Oxalate nephropathy analysis: A case series from a single center

Area of Science:

• Nephrology
• Gastroenterology
• Genetics

Background:

• Enteric hyperoxaluria frequently causes secondary oxalate nephropathy (ON).
• Pancreatic exocrine insufficiency (PEI) is a common, yet often underestimated, cause of enteric hyperoxaluria due to atypical symptoms.
• Screening for PEI and its etiology is critical for managing patients with ON.

Purpose of the Study:

• To investigate the prevalence and etiological factors of PEI in patients diagnosed with oxalate nephropathy (ON) and acute kidney injury (AKI).
• To highlight the importance of identifying PEI in the context of secondary ON and enteric hyperoxaluria.

Main Methods:

• Retrospective analysis of 6 patients with pathological diagnosis of ON and AKI.
• Assessment of pancreatic exocrine function using fecal elastase-1.
• Genetic testing and bioinformatics analyses for patients with chronic pancreatitis (CP).

Main Results:

• Among 6 ON patients, 4 had increased oxalate absorption due to PEI or increased intake.
• Three patients had PEI, with two diagnosed with CP and identified SPINK1 or PRSS1 mutations.
• Renal function outcomes varied, with complete recovery in 2, progression to end-stage kidney disease in 1.

Conclusions:

• Kidney biopsy aids in determining AKI causes.
• Secondary ON diagnosis warrants PEI screening, particularly for enteric hyperoxaluria.
• Investigating PEI etiology, including genetic testing for CP, is recommended.