Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 12;15(2):194-204.
doi: 10.1093/ckj/sfab145. eCollection 2022 Feb.

Oxalate nephropathy: a review

Jordan L Rosenstock  1 , Tatyana M J Joab  1 , Maria V DeVita  1 , Yihe Yang  2 , Purva D Sharma  3 , Vanesa Bijol  2
Affiliations

Oxalate nephropathy: a review

Jordan L Rosenstock et al. Clin Kidney J. .

Abstract

This review describes the clinical and pathological features of oxalate nephropathy (ON), defined as a syndrome of decreased renal function associated with deposition of calcium oxalate crystals in kidney tubules. We review the different causes of hyperoxaluria, including primary hyperoxaluria, enteric hyperoxaluria and ingestion-related hyperoxaluria. Recent case series of biopsy-proven ON are reviewed in detail, as well as the implications of these series. The possibility of antibiotic use predisposing to ON is discussed. Therapies for hyperoxaluria and ON are reviewed with an emphasis on newer treatments available and in development. Promising research avenues to explore in this area are discussed.

Keywords: acute kidney injury; oxalate nephropathy; pathology; primary hyperoxaluria; secondary hyperoxaluria.

PubMed Disclaimer

Figures

FIGURE 1:
FIGURE 1:
Renal oxalosis: (A) Massive deposition of oxalate crystals is noted in tubules with associated advanced chronic tubulointerstitial disease with atrophy and dropout of tubules and prominent interstitial fibrosis and nonspecific inflammation (H&E, bright field, 40X). (B) Same area visualized under polarized light reveals numerous intratubular crystals (H&E, polarized light, 40X). (C) Intratubular oxalate crystals are often transparent or reveal yellow or gray color, with needle or other shapes of crystals (H&E, bright field, 600X). (D) Same area visualized under polarized light reveals colorful crystals (H&E, polarized light, 600X)
FIGURE 2:
FIGURE 2:
Simplified hepatic pathways of glyoxylate metabolism
FIGURE 3:
FIGURE 3:
Metabolism of ethylene glycol to oxalate
FIGURE 4:
FIGURE 4:
Calcium Oxalate Monohydrate and Calcium Oxalate Dihydrate crystals in spun urine Reproduced according to License CC BY-SA 3.0. Photo by Doruk Salanci
FIGURE 5:
FIGURE 5:
Metabolism of ascorbic acid (vitamin C) to oxalate
See this image and copyright information in PMC

References

    1. Lumlertgul N, Siribamrungwong M, Jaber BL et al. Secondary oxalate nephropathy: a systematic review. Kidney Int Rep 2018; 3: 1363–1372 - PMC - PubMed
    1. Buysschaert B, Aydin S, Morelle J et al. Etiologies, clinical features, and outcome of oxalate nephropathy. Kidney Int Rep 2020; 5: 1503–1509 - PMC - PubMed
    1. Yang Y, Sharma PD, Nair V et al. Kidney oxalate crystal deposition in adult patients: a relatively common finding. Clin Nephrol 2020; 93: 243–250 - PubMed
    1. Nasr SH, D’Agati VD, Said SM et al. Oxalate nephropathy complicating Roux-en-Y gastric bypass: An underrecognized cause of irreversible renal failure. Clin J Am Soc Nephrol 2008; 3: 1676–1683 - PMC - PubMed
    1. Cartery C, Faguer S, Karras A et al. Oxalate nephropathy associated with chronic pancreatitis. Clin J Am Soc Nephrol 2011; 6: 1895–1902 - PMC - PubMed