title: [Primary hyperoxaluria].
abstract: Primary hyperoxalurias are rare recessive inherited inborn errors of glyoxylate metabolism. They are responsible for progressive renal involvement, which further lead to systemic oxalate deposition, which can even occur in infants. Primary hyperoxaluria type 1 is the most common form in Europe and is due to alanine-glyoxylate aminostransferase deficiency, a hepatic peroxisomal pyridoxin-dependent enzyme. Therefore primary hyperoxaluria type 1 is responsible for hyperoxaluria leading to aggressive stone formation and nephrocalcinosis. As glomerular filtration rate decreases, systemic oxalate storage occurs throughout all the body, and mainly in the skeleton. The diagnosis is first based on urine oxalate measurement, then on genotyping, which may also allow prenatal diagnosis to be proposed. Conservative measures - including hydration, crystallization inhibitors and pyridoxine - are safe and may allow long lasting renal survival, provided it is given as soon as the diagnosis has been even suspected. No dialysis procedure can remove enough oxalate to compensate oxalate overproduction from the sick liver, therefore a combined liver and kidney transplantation should be planned before advanced renal disease has occurred, in order to limit/avoid systemic oxalate deposition. In the future, primary hyperoxaluria type 1 may benefit from hepatocyte transplantation, chaperone molecules, etc.
authors.affiliation: Centre de référence des maladies rénales rares, hôpital Femme-Mère-Enfant, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France. pierre.cochat@chu-lyon.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Cochat
authors.forename: Sonia
authors.initials: S
authors.lastname: Fargue
authors.forename: Justine
authors.initials: J
authors.lastname: Bacchetta
authors.forename: Aurélia
authors.initials: A
authors.lastname: Bertholet-Thomas
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Sabot
authors.forename: Jérôme
authors.initials: J
authors.lastname: Harambat
mesh_terms: D000410:Alanine Transaminase / Q000172:deficiency / Q000235:genetics; D018450:Disease Progression; D005838:Genotype; D006801:Humans; D006959:Hyperoxaluria / Q000235:genetics / Q000652:urine; D006960:Hyperoxaluria, Primary / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy / Q000652:urine; D016030:Kidney Transplantation; D016031:Liver Transplantation; D009154:Mutation; D010530:Peritoneal Dialysis; D011736:Pyridoxine / Q000627:therapeutic use; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D014803:Vitamin B Complex; D000410:Alanine Transaminase; D011736:Pyridoxine