The Clinical and Pathological Characteristics of Patients with Oxalate Nephropathy

Llanos, Maria; Kwon, Alvin; Herlitz, Leal; Shafi, Tariq; Cohen, Scott; Gebreselassie, Surafel K.; Sawaf, Hanny; Bobart, Shane A.

doi:10.34067/kid.0000000000000340

Cited by 5 publications

(2 citation statements)

References 22 publications

(42 reference statements)

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“…7 Patients with type 2 and 3 often present with less severe disease that rarely progress to ESRD. 7,8 Systemic oxalosis is the term used to describe the deposition of calcium-oxalate salts into extra-renal tissues; this happens when the renal capacity to excrete calcium oxalate salts becomes significantly impaired. 8 Calcium-oxalate salts might get deposited into various tissues including heart, bone marrow, skin, bone, joints, and eyes leading to organ damage.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 Systemic oxalosis is the term used to describe the deposition of calcium-oxalate salts into extra-renal tissues; this happens when the renal capacity to excrete calcium oxalate salts becomes significantly impaired. 8 Calcium-oxalate salts might get deposited into various tissues including heart, bone marrow, skin, bone, joints, and eyes leading to organ damage. 9 The literature about oral and dental manifestations in hyperoxaluria is sparse, and deposition of calciumoxalate salts into oral tissues has been rarely reported.…”

Section: Introductionmentioning

confidence: 99%

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Primary hyperoxaluria: Description of a new oral finding and review of literature

Hassona,

Hassan,

Atef

et al. 2024

Special Care in Dentistry

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ObjectivesOro‐dental manifestations of hyperoxaluria and dental management of affected patients are rarely reported in the literature. We describe a new oral presentation of primary hyperoxaluria (PH) and review relevant literature about oro‐dental manifestations and management of dental complications of hyperoxaluria.MethodsA case report of a 44‐year‐old female who presented with symptoms of temporomandibular joint dysfunction due to hyperoxaluria was described according to the CARE guidelines. In addition, an extensive search of biomedical databases (PubMed, Medline, Google Scholar, and Embase) for articles describing oro‐dental manifestations and/or dental management in patients with hyperoxaluria was performed using the key words (“oral” and/or “hyperoxaluria” and/or “dental” and/or “oxalosis”). Included articles were reviewed and data about patient demographics, disease type and stage, oral and dental manifestations, and dental treatment outcome were retrieved and analyzed.ResultsA total of 14 articles describing the oral and dental manifestations in 15 patients with hyperoxaluria were included. Tooth mobility, root resorption, and radiographic alterations were consistently described in all cases. Oral manifestations were described mainly in PH at late stages, and only after the onset of chronic renal disease. Dental management in all reported cases was palliative and aimed to relive pain and treat periodontal infection. Tooth loss due to extraction or uncontrolled mobility was the ultimate outcome in almost all reported cases.ConclusionOral and dental manifestations in hyperoxaluria are rarely reported in the literature. Management of tooth mobility and root resorption in hyperoxaluria is challenging and clinical guidelines and evidence‐based recommendations are lacking. Early diagnosis and treatment of hyperoxaluria might be the only effective approach to prevent dental and periodontal complications of the disease.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Primary hyperoxaluria: Description of a new oral finding and review of literature

Hassona,

Hassan,

Atef

et al. 2024

Special Care in Dentistry

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NINJ1-mediated macrophage plasma membrane rupture and neutrophil extracellular trap formation contribute to oxalate nephropathy

Lin,

Yuan,

et al. 2024

Nephrology Dialysis Transplantation

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Background and hypothesis Oxalate nephropathy is characterized by calcium oxalate crystals deposition, which triggers necrosis of renal tubular epithelial cells, initiates an inflammatory cascade characterized by neutrophil and macrophage activation within the renal microenvironment. Despite the close association of immune cells with acute oxalate nephropathy, the underlying mechanisms still remain unclear. Nerve injury-induced protein 1 (NINJ1) plays an essential role in the induction of plasma membrane rupture (PMR), leading to damage-associated molecular patterns (DAMPs) release and triggering inflammation. We hypothesize that NINJ1-mediated high mobility group box 1 (HMGB1) release from macrophage PMR and neutrophil extracellular traps (NETs) formation synergistically contribute to the progression of acute oxalate nephropathy. Methods Using a murine model of acute oxalate nephropathy, myeloid cell-specific deletion of Ninj1 mice (Ninj1fl/flvavcre) and their wild-type littermate control mice (Ninj1wt/wtvavcre) were administered intraperitoneal injection of 100 mg/kg sodium oxalate followed by drinking water with 3% sodium oxalate. Evaluation was conducted on tubular injury and inflammatory cell infiltration. In vitro studies involved isolation and culture of renal proximal tubular epithelial cells (RTECs), bone marrow-derived macrophages, and neutrophils to investigate NETs formation and HMGB1 release. Results Targeted deletion of Ninj1 in myeloid cells significantly mitigated oxalate-induced acute kidney injury by suppressing both HMGB1 release and NETs formation in vivo. In vitro investigations demonstrated that HMGB1 release from macrophage PMR and NETs formation in neutrophils mediated by NINJ1 oligomerization, which consequently coordinated to enhance renal tubular epithelial cell death. Conclusion Our findings elucidate the pivotal role of NINJ1-dependent macrophage PMR and NETs formation in the progression of acute oxalate nephropathy, providing novel insights for its prevention and therapeutic targets.

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Oxalate Nephropathy After Kidney Transplantation: Risk Factors and Outcomes of Two Phenotypes

Garg,

Nguyen,

Astor

et al. 2024

Clinical Transplantation

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Describing risk factors and outcomes in kidney transplant recipients with oxalate nephropathy (ON) may help elucidate the pathogenesis and guide treatment strategies. We used a large single‐center database to identify patients with ON and categorized them into delayed graft function with ON (DGF‐ON) and late ON. Incidence density sampling was used to select controls. A total of 37 ON cases were diagnosed between 1/2011 and 1/2021. DGF‐ON (n = 13) was diagnosed in 1.05% of the DGF population. Pancreatic atrophy on imaging (36.4% vs. 2.9%, p = 0.002) and gastric bypass history (7.7% vs. 0%; p = 0.06) were more common in DGF‐ON than with controls with DGF requiring biopsy but without evidence of ON. DGF‐ON was not associated with worse graft survival (p = 0.98) or death‐censored graft survival (p = 0.48). Late ON (n = 24) was diagnosed after a mean of 78.2 months. Late ON patients were older (mean age 55.1 vs. 48.4 years; p = 0.02), more likely to be women (61.7% vs. 37.5%; p = 0.03), have gastric bypass history (8.3% vs. 0.8%; p = 0.02) and pancreatic atrophy on imaging (38.9% vs. 13.3%; p = 0.02). Late ON was associated with an increased risk of graft failure (HR 2.0; p = 0.07) and death‐censored graft loss (HR 2.5; p = 0.10). We describe two phenotypes of ON after kidney transplantation: DGF‐ON and late ON. Our study is the first to our knowledge to evaluate DGF‐ON with DGF controls without ON. Although limited by small sample size, DGF‐ON was not associated with adverse outcomes when compared with controls. Late ON predicted worse allograft outcomes.

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The Clinical and Pathological Characteristics of Patients with Oxalate Nephropathy

Cited by 5 publications

References 22 publications

Primary hyperoxaluria: Description of a new oral finding and review of literature

Primary hyperoxaluria: Description of a new oral finding and review of literature

NINJ1-mediated macrophage plasma membrane rupture and neutrophil extracellular trap formation contribute to oxalate nephropathy

Oxalate Nephropathy After Kidney Transplantation: Risk Factors and Outcomes of Two Phenotypes

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