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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Diet-induced oxalate nephropathy
  1. Barbara Clark1,
  2. Mohammad Wisam Baqdunes1 and
  3. Gregory M Kunkel2
  1. 1 Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  2. 2 School of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Barbara Clark, barbara.clark{at}ahn.org

Abstract

Oxalate nephropathy is a rare condition and may be overlooked due to lack of recognition and understanding of triggers. An 81-year-old man was sent to nephrologist because of significantly increased creatinine (1.5–1.9 mg/dL) noted for 3 months. He had well-controlled diabetes but no history of kidney disease. He had no chronic diarrhoea or intestinal surgery. He was a health-minded individual who had read extensively about benefit of antioxidants. Initial work-up was unrevealing. Within a few weeks after first visit, he developed acute symptomatic worsening kidney injury with nausea, vomiting and creatinine up to 6.8 mg/dL. Repeat examination of the urine sediment revealed casts containing calcium oxalate crystals. A deeper dietary history revealed widespread oxalate precursor consumption. A kidney biopsy confirmed oxalate nephropathy. Restriction of oxalate consumption combined with adequate hydration, oral calcium acetate resulted in partial renal recovery without need for haemodialysis.

  • nutrition
  • renal system
  • urinary and genital tract disorders
  • acute renal failure

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2019-231284

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    Footnotes

    • Contributors BC, MWB and GMK participated in the clinical care or diagnostic testing, assembling of data, contributed to the intellectual content of the case report, writing of the case report, and actively reviewed and edited the content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.