Service de Néphrologie-Dialyse-Transplantation, CHU d'Angers, 4 rue Larrey, 49933, Angers cedex 9, France.
Int Urol Nephrol. 2013 Aug;45(4):1209-13. doi: 10.1007/s11255-012-0140-1. Epub 2012 Mar 1.
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).
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.
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.
高草酸尿症是一种罕见的代谢紊乱，其特征是草酸钙在不同组织中的沉积。它要么是由草酸代谢的遗传性疾病引起的（原发性高草酸尿症 [PH]），要么是由获得性紊乱引起的（继发性高草酸尿症）。
我们在此报告一例在肝移植后发生的肠源性高草酸尿症诱导性肾衰竭的非典型表现。尽管进行了适应性治疗和强化血液透析，患者仍未恢复。该病例允许对涉及这种疾病的多种病理生理机制进行回顾。
在急性肾衰竭的鉴别诊断中应考虑草酸肾病，特别是当存在先前的肾功能损害和脂肪吸收不良时。我们建议早期进行肾活检，以便及时诊断和治疗干预。
