Primary hyperoxaluria: case report and therapeutic perspectives

Abstract

Primary hyperoxaluria (PH) is a rare genetic disorder with autosomal recessive transmission, characterized by high endogenous production and markedly excessive urinary excretion of oxalate (Ox). It causes the accumulation of calcium oxide crystals in organs and tissues including bones, heart, arteries, skin and kidneys, where it may cause oxalo-calcic nephrolithiasis, nephrocalcinosis and chronic renal failure. Some forms are secondary to enteric diseases, drugs or dietetic substances, while three primitive forms, caused by various enzymatic defects, are currently known: PH1, PH2 and PH3.

An early diagnosis, with the aid of biochemical and genetic investigations, helps prevent complications and establish a therapeutic strategy that often includes liver and liver-kidney transplantation, improving the prognosis of these patients.

In this work we describe the clinical case of a patient with PH1 undergoing extracorporeal hemodialysis treatment and we report the latest research results that could change the life of patients with PH.

 

Keywords: primitive hyperoxaluria, PH, nephrocalcinosis, chronic renal failure

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Caso clinico

In questo lavoro descriviamo il caso clinico di una donna di 61 anni di razza caucasica che, 12 anni fa, veniva in consulenza direttamente dal Pronto Soccorso del nostro ospedale con un quadro di insufficienza renale cronica (IRC) terminale. L’anamnesi familiare era positiva per ossalosi renale: un fratello della paziente era infatti deceduto all’età di 33 anni per nefropatia da ossalato di calcio (come da referto della composizione chimica del calcolo), trattata con terapia emodialitica intervallata da due trapianti di rene sia da donatore vivente (la madre), che da donatore cadavere. 

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