Clinical pathological features and prognosis of patients with secondary oxalate nephropathy manifesting as acute kidney injury
10.3760/cma.j.cn441217-20241118-01130
- VernacularTitle:表现为急性肾损伤的继发性草酸盐肾病患者临床病理特征及预后
- Author:
Ju WANG
1
;
Jianping XIAO
1
;
Deguang WANG
1
Author Information
1. 安徽医科大学第二附属医院肾脏内科，合肥 230601
- Publication Type:Journal Article
- Keywords:
Oxalates;
Acute kidney injury;
Prognosis;
Oxalate nephropathy;
Clinical pathology
- From:
Chinese Journal of Nephrology
2025;41(10):744-748
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To conduct a comprehensive analysis of the clinical, pathological characteristics and prognosis of patients with secondary oxalate nephropathy manifested by acute kidney injury.Methods:A retrospective analysis study was conducted on secondary oxalate nephropathy presenting with acute kidney injury and diagnosed by renal biopsy in the Department of Nephrology of the Second Affiliated Hospital of Anhui Medical University from August 2020 to July 2023. The general demographic characteristics, complications and laboratory tests were collected. All patients were followed from the time of diagnosis of oxalate nephropathy until death, loss to follow-up or the end of the study (October 2024). The primary endpoint event was the recovery of renal function.Results:During the study period, a total of 329 patients underwent renal biopsies. Among them, 12 patients (3.65%) with secondary oxalate nephropathy were included in this study, including 7 males (7/12) and 5 females (5/12), with age of 56.5 (50.0, 69.0) years. In terms of comorbidities, 5 patients (5/12) had diabetes mellitus, 8 patients (8/12) had hypertension, and 3 patients (3/12) had gastrointestinal diseases. Among the causes, 3 patients (3/12) were identified as having a high-oxalate diet, 1 patient (1/12) underwent gastric cancer surgery, and 3 patients (3/12) took medications that could induce hyperoxalemia. Additionally, no definitive cause was identified in 5 patients (5/12). All 12 patients exhibited acute tubulointerstitial injury on renal pathology, with 8 patients also demonstrating chronic tubulointerstitial lesions. Management strategies included the removal of causative factors, adequate hydration to promote oxalate excretion, and sodium bicarbonate to alkalize urine and vitamin B6 to reduce oxalate production, along with renal replacement therapy if necessary. During the follow-up of 28 (16, 39) months, 6 patients (6/10) achieved complete recovery of renal function, 4 patients (4/10) showed partial recovery, and 2 patients were lost to follow-up.Conclusions:The prevalence of secondary oxalate nephropathy at our center is 3.65%. Renal pathology in all patients demonstrates acute tubulointerstitial injury, with most patients exhibiting chronic tubulointerstitial lesions. Overall, the clinical prognosis remains favorable.
