Deurvorst Sten E, Alberga Job J, van Tellingen Anne, Flens Marcel J
Zaans Medisch Centrum, afd. Interne Geneeskunde, Zaandam.
Contact: S.E. Deurvorst (
Ned Tijdschr Geneeskd. 2018 Aug 23;162:D2782.
Enteric oxalate nephropathy is caused by hyperoxaluria. Factors which contribute to excessive oxalate absorption are an abundance of free fatty acids in the intestine due to malabsorption, changes in the microbiome, and bowel inflammation. We present two cases that illustrate different pathophysiological aspects of this disease. The first patient was a 70-year-old male who developed oxalate nephropathy through malabsorption caused by chronic pancreatitis. It is plausible that the oxalate nephropathy was set off by antibiotic treatment which influenced the microbiome. The second patient was a 63-year-old male who underwent a Roux-en-Y gastric bypass. The associated malabsorption resulted in oxalate nephropathy. Kidney biopsies from both patients showed typical oxalate crystals. Therapeutic regimens using calcium supplementation, steroids, and a low oxalate diet are rational treatments, which have proven to prevent deterioration of renal function in some patients.
肠道草酸肾病由高草酸尿症引起。导致草酸盐吸收过多的因素包括由于吸收不良导致肠道中存在大量游离脂肪酸、微生物群变化和肠道炎症。我们介绍两例病例，以说明该疾病不同的病理生理方面。首例患者为一名70岁男性，因慢性胰腺炎引起的吸收不良而患上草酸肾病。抗生素治疗影响了微生物群，从而引发草酸肾病，这似乎是合理的。第二例患者为一名63岁男性，接受了Roux-en-Y胃旁路手术。相关的吸收不良导致了草酸肾病。两名患者的肾活检均显示有典型的草酸钙结晶。使用补钙、类固醇和低草酸饮食的治疗方案是合理的治疗方法，已被证明可防止一些患者的肾功能恶化。
