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Acquired hyperoxaluria and haematuria in children

A Voghenzi1, T M Bezzi, P Lusardi

  • 1Paediatric Institute, Ferrara University, Italy.

Insights

Children who underwent extensive ileal resection can develop acquired hyperoxaluria, leading to non-glomerular haematuria. This suggests hyperoxaluria may cause haematuria through a mechanism similar to hypercalciuria.

Area of Science:

  • Nephrology
  • Pediatric Gastroenterology
  • Urology

Background:

  • Intestinal disorders, particularly following extensive ileal resection, are associated with acquired hyperoxaluria in children.
  • Gross haematuria of non-glomerular origin, without evidence of kidney stones or nephrocalcinosis, is a concerning clinical presentation in pediatric patients.

Observation:

  • Two pediatric cases with extensive ileal resection presented with significant gross haematuria.
  • These children did not exhibit urolithiasis or nephrocalcinosis, ruling out common causes of haematuria.

Findings:

  • Both patients demonstrated elevated urinary oxalate levels, confirming acquired hyperoxaluria.
  • The presence of hyperoxaluria in these cases suggests a potential link to the observed haematuria.

Implications:

  • Acquired hyperoxaluria secondary to ileal resection may be a novel cause of non-glomerular haematuria in children.
  • This finding warrants further investigation into the pathogenetic mechanisms linking hyperoxaluria to haematuria, potentially mirroring pathways seen with hypercalciuria and hyperuricosuria.

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