Cargando…

Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass

Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) increases the risk for kidney injury. Medical therapies for hyperoxaluria have limited efficacy. A 65-year-old female was evaluated for acute kidney injury [AKI, serum creatinine (Cr) 2.1 mg/dl, baseline Cr 1.0 mg/dl]. She did not have any urinary...

Descripción completa

Detalles Bibliográficos
Autores principales: Agrawal, Varun, Wilfong, Jonathan B., Rich, Christopher E., Gibson, Pamela C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073683/
https://www.ncbi.nlm.nih.gov/pubmed/27781207
http://dx.doi.org/10.1159/000449128
_version_ 1782461620033683456
author Agrawal, Varun
Wilfong, Jonathan B.
Rich, Christopher E.
Gibson, Pamela C.
author_facet Agrawal, Varun
Wilfong, Jonathan B.
Rich, Christopher E.
Gibson, Pamela C.
author_sort Agrawal, Varun
collection PubMed
description Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) increases the risk for kidney injury. Medical therapies for hyperoxaluria have limited efficacy. A 65-year-old female was evaluated for acute kidney injury [AKI, serum creatinine (Cr) 2.1 mg/dl, baseline Cr 1.0 mg/dl]. She did not have any urinary or gastrointestinal symptoms or exposure to nephrotoxic agents. Sixteen months prior to this evaluation, she underwent RYGB for morbid obesity. Her examination was unremarkable for hypertension or edema and there was no protein or blood on urine dipstick. Kidney biopsy revealed acute tubulointerstitial nephritis with oxalate crystals in tubules. The concurrent finding of severe hyperoxaluria (urine oxalate 150 mg/day) confirmed the diagnosis of oxalate nephropathy. Despite medical management of hyperoxaluria, her AKI worsened. Laparoscopic reversal of RYGB was performed and within 1 month, her hyperoxaluria resolved (urine oxalate 20 mg/day) and AKI improved (Cr 1.7 mg/dl). Surgical reversal of RYGB may be considered in patients with oxalate nephropathy at high risk of progression who fail medical therapy. Physicians need to be aware of the possibility of oxalate nephropathy after RYGB and promptly treat the hyperoxaluria to halt further kidney damage.
format Online
Article
Text
id pubmed-5073683
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher S. Karger AG
record_format MEDLINE/PubMed
spelling pubmed-50736832016-10-25 Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass Agrawal, Varun Wilfong, Jonathan B. Rich, Christopher E. Gibson, Pamela C. Case Rep Nephrol Dial Case Report Hyperoxaluria after Roux-en-Y gastric bypass (RYGB) increases the risk for kidney injury. Medical therapies for hyperoxaluria have limited efficacy. A 65-year-old female was evaluated for acute kidney injury [AKI, serum creatinine (Cr) 2.1 mg/dl, baseline Cr 1.0 mg/dl]. She did not have any urinary or gastrointestinal symptoms or exposure to nephrotoxic agents. Sixteen months prior to this evaluation, she underwent RYGB for morbid obesity. Her examination was unremarkable for hypertension or edema and there was no protein or blood on urine dipstick. Kidney biopsy revealed acute tubulointerstitial nephritis with oxalate crystals in tubules. The concurrent finding of severe hyperoxaluria (urine oxalate 150 mg/day) confirmed the diagnosis of oxalate nephropathy. Despite medical management of hyperoxaluria, her AKI worsened. Laparoscopic reversal of RYGB was performed and within 1 month, her hyperoxaluria resolved (urine oxalate 20 mg/day) and AKI improved (Cr 1.7 mg/dl). Surgical reversal of RYGB may be considered in patients with oxalate nephropathy at high risk of progression who fail medical therapy. Physicians need to be aware of the possibility of oxalate nephropathy after RYGB and promptly treat the hyperoxaluria to halt further kidney damage. S. Karger AG 2016-09-20 /pmc/articles/PMC5073683/ /pubmed/27781207 http://dx.doi.org/10.1159/000449128 Text en Copyright © 2016 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Agrawal, Varun
Wilfong, Jonathan B.
Rich, Christopher E.
Gibson, Pamela C.
Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass
title Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass
title_full Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass
title_fullStr Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass
title_full_unstemmed Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass
title_short Reversal of Gastric Bypass Resolves Hyperoxaluria and Improves Oxalate Nephropathy Secondary to Roux-en-Y Gastric Bypass
title_sort reversal of gastric bypass resolves hyperoxaluria and improves oxalate nephropathy secondary to roux-en-y gastric bypass
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5073683/
https://www.ncbi.nlm.nih.gov/pubmed/27781207
http://dx.doi.org/10.1159/000449128
work_keys_str_mv AT agrawalvarun reversalofgastricbypassresolveshyperoxaluriaandimprovesoxalatenephropathysecondarytorouxenygastricbypass
AT wilfongjonathanb reversalofgastricbypassresolveshyperoxaluriaandimprovesoxalatenephropathysecondarytorouxenygastricbypass
AT richchristophere reversalofgastricbypassresolveshyperoxaluriaandimprovesoxalatenephropathysecondarytorouxenygastricbypass
AT gibsonpamelac reversalofgastricbypassresolveshyperoxaluriaandimprovesoxalatenephropathysecondarytorouxenygastricbypass