Rapidly progressive irreversible renal failure in patients with pancreatic insufficiency

Hill, Peter; Karim, Mahzuz; Davies, David R.; Roberts, Ian S.; Winearls, Christopher G.

doi:10.1016/s0272-6386(03)00948-x

Cited by 19 publications

(17 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, prognosis of AON is poor. AON mostly occurs in patients with pre-existing CKD, mainly related to diabetic nephropathy (5,13). Consistent with data issued from patients with jejuno-ileal bypass (5), pre-existing CKD seems to be a prognosis factor of renal function worsening: in our series three of seven individuals with stage 3 CKD subsequently required RRT at the end of the follow-up and three reached stage 4 CKD.…”

Section: Discussionsupporting

confidence: 89%

“…This finding remains speculative as a marked increase in urine oxalate after antibiotic use has not been shown. Third, recent dehydration (vomiting, diarrhea, and diuretics) or renin-angiotensin system (RAS) inhibitors intake are frequently reported in patients with AON (5,10,13). Increased intratubular concentration of oxalate, secondary to enhanced reabsorption of sodium and water in the proximal tubule, likely explains the propensity of AON to be triggered by extracellular depletion.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Oxalate Nephropathy Associated with Chronic Pancreatitis

Cartery¹,

Faguer²,

Karras³

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives Enteric overabsorption of oxalate may lead to hyperoxaluria and subsequent acute oxalate nephritis (AON). AON related to chronic pancreatitis is a rare and poorly described condition precluding early recognition and treatment.Design, setting, participants, & measurements We collected the clinical characteristics, treatment, and renal outcome of 12 patients with chronic pancreatitis-associated AON followed in four French renal units.Results Before AON, mild to moderate chronic kidney disease was present in all patients, diabetes mellitus in eight (insulin [n ϭ 6]; oral antidiabetic drugs [n ϭ 2]), and known chronic pancreatitis in only eight. At presentation, pancreas imaging showed gland atrophy/heterogeneity, Wirsung duct dilation, calcification, or pseudocyst. Renal findings consisted of rapidly progressive renal failure with tubulointerstitial profile. Acute modification of glomerular filtration preceded the AON (i.e., diarrhea and diuretics). Increase in urinary oxalate excretion was found in all tested patients and hypocalcemia in nine (Ͻ1.5 mmol/L in four patients). Renal biopsy showed diffuse crystal deposits, highly suggestive of oxalate crystals, with tubular necrosis and interstitial inflammatory cell infiltrates. Treatment consisted of pancreatic enzyme supplementation, oral calcium intake, and an oxalate-free diet in all patients and renal replacement therapy in five patients. After a median follow-up of 7 months, three of 12 patients reached end-stage renal disease.Conclusion AON is an under-recognized severe crystal-induced renal disease with features of tubulointerstitial nephritis that may occur in patients with a long history of chronic pancreatitis or reveal the pancreatic disease. Extrinsic triggering factors should be prevented.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Oxalate Nephropathy Associated with Chronic Pancreatitis

Cartery¹,

Faguer²,

Karras³

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Hyperoxalosis from any cause converges on a common final pathophysiological pathway of supersaturation of the renal tubular fluid leading to the precipitation of oxalate crystals in the renal interstitium creating an interstitial nephritis, macrophage recruitment and surge in inflammatory mediators ultimately leading to tubular atrophy and AKI [5]. Secondary oxalosis in native kidneys is well documented and can cause AKI resulting in a rapid loss of kidney function [6–9]. …”

Section: Discussionmentioning

confidence: 99%

Secondary oxalosis induced acute kidney injury in allograft kidneys

Suneja

Kumar

2013

Clin Kidney J

View full text Add to dashboard Cite

Secondary oxalosis causing acute kidney injury (AKI) has been widely reported in native kidneys but its occurrence in allograft kidneys is relatively uncommon. We present three patients with acute kidney allograft dysfunction secondary to tubular oxalate microcrystal deposits confirmed on allograft biopsy in the setting of acute gastrointestinal dysfunction. These three patients presented with AKI that was preceded by episodes of ongoing diarrhea ranging from 10 to 90 days. All patients were on vitamin C and/or multivitamin supplementation. Two of the three patients needed long-term renal replacement therapy with the third patient recovering his kidney function after 2 months. The risks versus benefits of vitamin C supplementation in renal transplant patients should be carefully evaluated especially in the setting of gastrointestinal dysfunction.

show abstract

“…The high rate of deterioration of renal failure in these patients it thought to be a result of the synergy between enteric hyperoxaluria and a reduction in renal excretory function caused by early diabetic nephropathy 121 . In a case of late renal transplant dysfunction due to acute oxalate nephropathy, a diagnosis of enteric hyperoxaluria secondary to pancreatic insufficiency was made.…”

Section: Pancreatic Insufficiencymentioning

confidence: 99%

Liquid chromatography–tandem mass spectrometry method for routine measurement of oxalic acid in human plasma

Elgstøen

2008

Journal of Chromatography B

View full text Add to dashboard Cite

Rapidly progressive irreversible renal failure in patients with pancreatic insufficiency

Cited by 19 publications

References 21 publications

Oxalate Nephropathy Associated with Chronic Pancreatitis

Oxalate Nephropathy Associated with Chronic Pancreatitis

Secondary oxalosis induced acute kidney injury in allograft kidneys

Liquid chromatography–tandem mass spectrometry method for routine measurement of oxalic acid in human plasma

Contact Info

Product

Resources

About