A case of oxalate nephropathy presenting with acute kidney injury

Abstract

Oxalate Nephropathy (ON) represents a serious condition characterized by a decline in renal function associated with calcium oxalate crystal deposition within renal tubules. It can arise from Primary Hyperoxaluria (PH) due to genetic defects or secondary causes such as increased dietary oxalate intake. We present a case of a 46-year-old male with facial puffiness, abdominal pain, and pedal oedema, diagnosed with acute kidney injury superimposed on probable chronic kidney disease. Diagnostic investigations revealed bilateral renal echogenicity and severe acute tubular injury with calcium oxalate crystal deposition on renal biopsy. A24-hour urinary oxalate analysis confirmed ON. Despite the absence of identifiable risk factors, the patient was categorized as probable primary oxalate nephropathy, pending genetic testing results. Management included thrice-weekly haemodialysis and assessment for liver-kidney transplant. Early identification and intervention are crucial in ON to prevent progression to renal failure, emphasizing the need for heightened clinical suspicion and timely management strategies.

Keywords

• oxalate nephropathy
• primary hyperoxaluria
• liver-kidney transplant