Division of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, B-1200, Brussels, Belgium.
Division of Pathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, B-1200, Brussels, Belgium.
BMC Nephrol. 2024 Mar 18;25(1):106. doi: 10.1186/s12882-024-03543-9.
A 75-year-old male developed acute kidney injury KDIGO stage 3 a few weeks after Whipple surgery was performed for a distal cholangiocarcinoma. Kidney biopsy revealed oxalate nephropathy. This was attributed to post-Whipple malabsorption, poor compliance with pancreatic enzyme replacement therapy, and daily intake of vitamin C supplements. Pancreatic enzyme replacement therapy was resumed and calcium carbonate initiated, with an improvement in glomerular filtration rate. Unfortunately, due to oncological progression, best supportive care was initiated.We review the pathophysiology and conditions predisposing to secondary hyperoxaluria and oxalate nephropathy. This diagnosis should be considered among the main causes of acute kidney injury following pancreatectomy, with important therapeutic implications.
一位 75 岁男性因远端胆管癌接受胰十二指肠切除术(Whipple 手术)后数周发生急性肾损伤 KDIGO 3 期。肾活检显示草酸肾病。这归因于 Whipple 手术后吸收不良、胰腺酶替代治疗依从性差和每日摄入维生素 C 补充剂。恢复了胰腺酶替代治疗并开始使用碳酸钙,肾小球滤过率得到改善。不幸的是,由于肿瘤进展,开始了最佳支持治疗。我们回顾了导致继发性高草酸尿症和草酸肾病的病理生理学和易患因素。在胰腺切除术后急性肾损伤的主要病因中应考虑到这一诊断,具有重要的治疗意义。