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Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation
Hyperoxaluria is an important and underrecognized cause for allograft dysfunction and loss after transplantation. It is potentially treatable if recognized in a timely fashion. Research is ongoing to expand the array of therapeutic options available to treat this. We present a case of a 59-year-old...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452533/ https://www.ncbi.nlm.nih.gov/pubmed/31019830 http://dx.doi.org/10.1155/2019/8942062 |
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author | Kelly, Yvelynne P. Weins, Astrid Yeung, Melissa Y. |
author_facet | Kelly, Yvelynne P. Weins, Astrid Yeung, Melissa Y. |
author_sort | Kelly, Yvelynne P. |
collection | PubMed |
description | Hyperoxaluria is an important and underrecognized cause for allograft dysfunction and loss after transplantation. It is potentially treatable if recognized in a timely fashion. Research is ongoing to expand the array of therapeutic options available to treat this. We present a case of a 59-year-old gentleman who underwent deceased donor renal transplantation that was complicated by delayed graft function necessitating continuation of renal replacement therapy. His initial biopsy showed extensive acute tubular necrosis with associated peritubular capillaritis and interstitial nephritis and oxalate crystals in several tubules. Despite receiving methylprednisolone to treat moderate acute cellular rejection, he remained dialysis dependent with minimal urine output. An interval renal allograft biopsy revealed residual acute tubular necrosis with extensive oxalate crystals now visible in many tubules. His plasma oxalate level was concurrently elevated to 19.3 μmol/L (reference range ≤ 1.9 μmol/L). He commenced calcium citrate to manage his hyperoxaluria and ultimately became dialysis independent at 3 weeks after transplantation. This case provides an important example of accelerated oxalate nephropathy as an underappreciated contributor to delayed graft function after renal transplantation. Our accompanying discussion provides an update on current therapeutic measures for managing this challenging condition. |
format | Online Article Text |
id | pubmed-6452533 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-64525332019-04-24 Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation Kelly, Yvelynne P. Weins, Astrid Yeung, Melissa Y. Case Rep Transplant Case Report Hyperoxaluria is an important and underrecognized cause for allograft dysfunction and loss after transplantation. It is potentially treatable if recognized in a timely fashion. Research is ongoing to expand the array of therapeutic options available to treat this. We present a case of a 59-year-old gentleman who underwent deceased donor renal transplantation that was complicated by delayed graft function necessitating continuation of renal replacement therapy. His initial biopsy showed extensive acute tubular necrosis with associated peritubular capillaritis and interstitial nephritis and oxalate crystals in several tubules. Despite receiving methylprednisolone to treat moderate acute cellular rejection, he remained dialysis dependent with minimal urine output. An interval renal allograft biopsy revealed residual acute tubular necrosis with extensive oxalate crystals now visible in many tubules. His plasma oxalate level was concurrently elevated to 19.3 μmol/L (reference range ≤ 1.9 μmol/L). He commenced calcium citrate to manage his hyperoxaluria and ultimately became dialysis independent at 3 weeks after transplantation. This case provides an important example of accelerated oxalate nephropathy as an underappreciated contributor to delayed graft function after renal transplantation. Our accompanying discussion provides an update on current therapeutic measures for managing this challenging condition. Hindawi 2019-03-25 /pmc/articles/PMC6452533/ /pubmed/31019830 http://dx.doi.org/10.1155/2019/8942062 Text en Copyright © 2019 Yvelynne P. Kelly et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Kelly, Yvelynne P. Weins, Astrid Yeung, Melissa Y. Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation |
title | Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation |
title_full | Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation |
title_fullStr | Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation |
title_full_unstemmed | Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation |
title_short | Accelerated Oxalosis Contributing to Delayed Graft Function after Renal Transplantation |
title_sort | accelerated oxalosis contributing to delayed graft function after renal transplantation |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6452533/ https://www.ncbi.nlm.nih.gov/pubmed/31019830 http://dx.doi.org/10.1155/2019/8942062 |
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