Successful strategies for renal transplantation in primary oxalosis.
Eleven patients, aged 6 months to 47 years, with renal failure due to primary oxalosis, received renal allografts and were followed for 1 to 9 years. A specialized strategy for medical management included intensive pre-transplant hemodialysis and post-transplant long-term diuresis, administration of neutral phosphate, Mg++, and pyridoxine. Seven of ten living-related (LRD) transplants have good renal function, six with no biopsy evidence of renal oxalate deposition at up to 7 years after transplant. Two LRD graft losses from recurrent oxalosis, accompanied by massive secondary oxalate deposits, occurred in patients following endstage renal failure for over 3 years. A third LRD graft loss occurred following long-term (6 month) peritoneal dialysis in an infant. One cadaver transplant recipient has survived with recurrent oxalosis and poor graft function for 9 years. It is possible to perform successful renal transplantation in small children and adults with primary oxalosis and to completely prevent the deposition of oxalate in the renal allograft. Renal transplantation, with a strict medical protocol, would appear to be the initial treatment of choice for renal failure due to primary oxalosis.
D000328:Adult; D001706:Biopsy; D002129:Calcium Oxalate / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D016030:Kidney Transplantation; D008274:Magnesium / Q000627:therapeutic use; D008297:Male; D008659:Metabolic Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D010070:Oxalates / Q000378:metabolism*; D010710:Phosphates / Q000627:therapeutic use; D011736:Pyridoxine / Q000627:therapeutic use; D006435:Renal Dialysis
D004232:Diuretics; D010070:Oxalates; D010710:Phosphates; D002129:Calcium Oxalate; D008274:Magnesium; D011736:Pyridoxine