期刊
AMERICAN JOURNAL OF KIDNEY DISEASES
卷 40, 期 1, 页码 -出版社
W B SAUNDERS CO
DOI: 10.1053/ajkd.2002.33934
关键词
oxalate nephropathy; early renal graft failure; hyperoxaluria; renal transplantation
A 37-year-old patient underwent two successive renal transplantations 7 months apart. He remained dialysis dependent. Early biopsy of both grafts revealed widespread calcium oxalate deposition suggestive:of acute oxalate nephropathy. Several causes of oxalate nephropathy, including primary oxalosis and an increased intake of oxalic acid precursors, were excluded. Two years later, the identification of steatorrhea with radiologic signs of chronic pancreatitis led to the hypothesis of enteric hyperoxaluria. Surprisingly, 11 months after the second transplantation, graft function improved progressively allowing Interruption of dialysis. Three years later, renal function is stable. The causes and,prevention of acute oxalate-induced graft failure are highlighted. Subclinical evidence of enteric hyperoxaluria should be looked for and appropriate therapy Instituted as early as possible. The possibility of a late recovery of renal function warrants attentive patience from attending physicians. (C) 2002 by the National Kidney Foundation, Inc.
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