An unexpected cause of progressive renal failure in a 66-year-old male after liver transplantation: secondary hyperoxaluria

François Beloncle, Johnny Sayegh, Agnès Duveau, Virginie Besson, Anne Croue, Jean-François Subra, Jean-François Augusto
International Urology and Nephrology 2013, 45 (4): 1209-13

BACKGROUND: Hyperoxaluria is a rare metabolic disorder characterized by calcium oxalate deposition in different tissues. It is caused either by an inherited disease of oxalate metabolism [primary hyperoxalurias (PH)] or by an acquired disturbance (secondary hyperoxaluria).

CASE: We report here an atypical presentation of enteric hyperoxaluria-induced renal failure that occurred after liver transplantation. Despite adapted treatment and intensive haemodialysis, the patient did not recover. This case allows the reviewing of the multiple pathophysiological mechanisms involved in this disease.

CONCLUSION: Oxalate nephropathy should be considered in the differential diagnosis of acute renal failure, especially when previous renal impairment and fat malabsorption are present. We suggest performing renal biopsy early to allow a prompt diagnosis and therapeutic intervention.

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