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一例因长期大量摄入维生素C导致肾草酸沉着症和继发性高草酸尿症的病例报告。

A case report of renal oxalosis and secondary hyperoxaluria due to chronic high vitamin C consumption.

作者信息

Neofytou Ioannis Eleftherios, Lioulios Georgios, Almaliotis Emmanouil, Daikidou Dimitra Vasilia, Mplatsa Aikaterini, Minasidis Elias

机构信息

Nephrology Department, 424 General Military Hospital of Thessaloniki, Thessaloniki, Central Macedonia, Greece.

出版信息

Clin Nephrol Case Stud. 2025 Mar 14;13:18-27. doi: 10.5414/CNCS111462. eCollection 2025.

DOI:10.5414/CNCS111462
PMID:40115864
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11924107/
Abstract

Renal oxalosis occurs from supersaturation of the urine with oxalate in the presence of calcium, resulting in deposition of calcium oxalate crystals within renal tissue and, consequently, progressive renal disease. One of the causes of secondary hyperoxaluria is a high intake of vitamin C, which exceeds the renal excretion capacity, and can induce renal oxalosis. We present a case involving a 67-year-old patient with chronic kidney disease and proteinuria, associated with secondary hyperoxaluria and renal oxalosis, who reported prolonged, excessive intake of vitamin C supplements. The patient presented with a gradual worsening of his renal function and proteinuria during the last 6-month period, after an episode of SARS-CoV-2 infection. The kidney biopsy revealed calcium oxalate crystals within the renal tissue. Thorough investigation and history-taking revealed a substantial increase in vitamin C supplementation during the SARS-CoV-2 infection (up to 3 g daily), indicating secondary hyperoxaluria as the causative factor. Overall during the pandemic, supplement consumption dramatically increased and patients were not adequately informed about the risks of various over-the-counter products. Excessive intake of vitamin C, popularized for its supposed health benefits, can lead, among others, to secondary hyperoxaluria and renal oxalosis. Prompt recognition is pivotal to initiate management and to prevent irreversible kidney damage.

摘要

肾草酸沉着症是由于尿液中草酸盐在有钙存在的情况下过饱和,导致草酸钙晶体在肾组织内沉积,进而引发进行性肾病。继发性高草酸尿症的病因之一是维生素C摄入过多,超过了肾脏的排泄能力,从而诱发肾草酸沉着症。我们报告了一例病例,患者为一名67岁的慢性肾病和蛋白尿患者,伴有继发性高草酸尿症和肾草酸沉着症,该患者自述长期过量服用维生素C补充剂。在感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)之后的6个月内,患者的肾功能和蛋白尿逐渐恶化。肾脏活检显示肾组织内有草酸钙晶体。全面的调查和病史采集发现,在感染SARS-CoV-2期间,维生素C补充量大幅增加(每天高达3克),表明继发性高草酸尿症是致病因素。在疫情大流行期间,补充剂的消费量大幅增加,而患者并未充分了解各种非处方产品的风险。因所谓的健康益处而广受欢迎的维生素C摄入过量,除其他外,可导致继发性高草酸尿症和肾草酸沉着症。及时识别对于启动治疗和预防不可逆转的肾损伤至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70d2/11924107/966dc8718b0a/cncs11146202.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70d2/11924107/bf4b190efec0/cncs11146201.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70d2/11924107/966dc8718b0a/cncs11146202.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70d2/11924107/bf4b190efec0/cncs11146201.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70d2/11924107/966dc8718b0a/cncs11146202.jpg

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