title: Acute oxalate nephropathy due to pancreatic atrophy in newly diagnosed pancreatic carcinoma.
abstract: Acute oxalate nephropathy can occur due to primary hyperoxaluria and secondary hyperoxaluria. The primary hyperoxalurias are a group of autosomal recessive disorders of endogenous oxalate overproduction. Secondary hyperoxaluria may occur as a result of excess dietary intake, poisoning with oxalate precursors (ethylene glycol), or enteric hyperoxaluria. The differential diagnosis of enteric hyperoxaluria includes inflammatory bowel disease, short bowel syndrome, bariatric surgery (with jejunoileal bypass or Roux-en-Y gastric bypass), celiac disease, partial colectomy, and chronic pancreatitis. The common etiology in all these processes is fat malabsorption, steatorrhea, saponification of calcium, and absorption of free oxalate. Hyperoxaluria causes increased urinary oxalate excretion, urolithiasis (promoted by hypovolemia, decreased urinary pH caused by metabolic acidosis, and decreased citrate and magnesium concentrations in urine), tubulointerstitial oxalate deposits, and tubulointerstitial nephritis. We report a rare case of acute oxalate nephropathy due to pancreatic atrophy and exocrine insufficiency caused by newly diagnosed pancreatic cancer.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Arizona Medical Center, Tucson, AZ 85724. Electronic address: irfamoinuddin@yahoo.com.
authors.forename: Irfan
authors.initials: I
authors.lastname: Moinuddin
authors.affiliation: Division of Nephrology, Department of Medicine, University of Arizona Medical Center, Tucson, AZ 85724. Electronic address: asifbala@gmail.com.
authors.forename: Asif
authors.initials: A
authors.lastname: Bala
authors.affiliation: Division of Nephrology, Department of Medicine, University of Arizona Medical Center, Tucson, AZ 85724. Electronic address: butool@gmail.com.
authors.forename: Butool
authors.initials: B
authors.lastname: Ali
authors.affiliation: Division of Nephrology, Department of Medicine, University of Arizona Medical Center, Tucson, AZ 85724. Electronic address: husnakhan@gmail.com.
authors.forename: Husna
authors.initials: H
authors.lastname: Khan
authors.affiliation: Department of Pathology, University of Arizona Medical Center, Tucson, AZ 85724. Electronic address: erikab@pathology.arizona.edu.
authors.forename: Erika
authors.initials: E
authors.lastname: Bracamonte
authors.affiliation: Division of Nephrology, Department of Medicine, University of Arizona Medical Center, Tucson, AZ 85724. Electronic address: asussman@deptofmed.arizona.edu.
authors.forename: Amy
authors.initials: A
authors.lastname: Sussman
mesh_terms: D000368:Aged; D001284:Atrophy; D003110:Colonic Neoplasms / Q000453:epidemiology; D005260:Female; D006801:Humans; D006959:Hyperoxaluria / Q000150:complications*; D007674:Kidney Diseases / Q000209:etiology*; D016609:Neoplasms, Second Primary / Q000473:pathology; D010051:Ovarian Neoplasms / Q000453:epidemiology; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000150:complications*; D014594:Uterine Neoplasms / Q000453:epidemiology
keywords: Cancer; Exocrine; Insufficiency; Nephropathy; Oxalosis; Pancreatic