Rapid progression of oxalosis-induced cardiomyopathy despite adequate haemodialysis.

Crystals of calcium oxalate (CaC2O4) were found at autopsy in the heart of a patient who, over a period of 11 months, appeared to receive adequate haemodialysis and yet died of rapidly progressive heart failure. Calcium oxalate crystals were not present in the kidneys which had been removed at the time of commencing haemodialysis. No secondary cause of oxalosis was evident. X-ray fluorescence analysis of the heart tissue revealed, as well as large amounts of calcium, excess strontium and markedly reduced amounts of potassium and rubidium.