[Acute kidney failure in secondary renal oxalosis. Additional indications for a causal connection to xylitol infusions].

A 35 years old female developed a slowly progressive acute renal failure after surgical drainage of a pancreatic abscess. Due to the uncharacteristic course a renal biopsy was performed which revealed a severe obstructive renal oxalosis with concomitant interstitial nephritis. Primary oxalosis was excluded by determination of glyceric and glycolic acid in the urine. Since other preconditions for increased oxalate formation were not present it was considered as an adverse reaction to the parenteral application of xylitol. During 4 weeks of total parenteral nutrition the patient received this sugar alcohol in a dose of 3.0 g/kg/day (total dose 4480 g). In recognition of preceding autopsy studies and recent experimental investigations on the metabolic pathways from xylitol to oxalate the chances and conditions of renal deposition of calcium oxalate after administration of xylitol are discussed.