[Primary hyperoxaluria: case report and therapeutic perspectives]

G Ital Nefrol. 2020 Feb 12;37(1):2020-vol1.
[Article in Italian]

Abstract

Primary hyperoxaluria (PH) is a rare genetic disorder with autosomal recessive transmission, characterized by high endogenous production and markedly excessive urinary excretion of oxalate (Ox). It causes the accumulation of calcium oxide crystals in organs and tissues including bones, heart, arteries, skin and kidneys, where it may cause oxalo-calcic nephrolithiasis, nephrocalcinosis and chronic renal failure. Some forms are secondary to enteric diseases, drugs or dietetic substances, while three primitive forms, caused by various enzymatic defects, are currently known: PH1, PH2 and PH3. An early diagnosis, with the aid of biochemical and genetic investigations, helps prevent complications and establish a therapeutic strategy that often includes liver and liver-kidney transplantation, improving the prognosis of these patients. In this work we describe the clinical case of a patient with PH1 undergoing extracorporeal hemodialysis treatment and we report the latest research results that could change the life of patients with PH.

Keywords: PH; chronic renal failure; nephrocalcinosis; primitive hyperoxaluria.

Publication types

  • Case Reports

MeSH terms

  • Calciphylaxis / etiology
  • Calciphylaxis / pathology
  • Calciphylaxis / therapy*
  • Calcium Compounds / metabolism
  • Female
  • Glyoxylates / metabolism
  • Hemodiafiltration / methods
  • Humans
  • Hyperoxaluria, Primary / diagnosis
  • Hyperoxaluria, Primary / genetics*
  • Hyperoxaluria, Primary / therapy*
  • Kidney Failure, Chronic / etiology
  • Kidney Transplantation
  • Middle Aged
  • Nephrocalcinosis / etiology
  • Nephrocalcinosis / therapy
  • Off-Label Use
  • Oxalates / metabolism
  • Oxides / metabolism
  • Renal Dialysis / methods*
  • Skin Diseases, Metabolic / etiology
  • Skin Diseases, Metabolic / pathology
  • Skin Diseases, Metabolic / therapy*
  • Thiosulfates / therapeutic use
  • Transaminases / genetics*

Substances

  • Calcium Compounds
  • Glyoxylates
  • Oxalates
  • Oxides
  • Thiosulfates
  • lime
  • Transaminases
  • Alanine-glyoxylate transaminase
  • glyoxylic acid