Dilemma of oxalosis in end stage renal failure: isolated kidney allograft or hemodialysis

We report the case of a 10-year-old girl who received a cadaveric kidney transplant for oxalosis after a period of 12 months on hemodialysis. The donor was a 6-year-old child. Cold ischemia was four hours. Diuresis occurred immediately in the operating room. Mean daily diuresis was maintained at 8 l...

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Bibliographic Details
Published inMaġallat al-ṭibbiyat al-lubnāniyyat Vol. 47; no. 5; p. 317
Main Authors Mourani, C, Mallat, S, Moukarzel, M, Bassil, Z, Akatcherian, C
Format Journal Article
LanguageEnglish
Published Lebanon 01.09.1999
Subjects
Biopsy
Child
Combined Modality Therapy
Female
Humans
Hyperoxaluria, Primary - pathology
Hyperoxaluria, Primary - therapy
Kidney - pathology
Kidney Failure, Chronic - pathology
Kidney Failure, Chronic - therapy
Kidney Function Tests
Kidney Transplantation
Renal Dialysis
Transplantation, Homologous
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Summary:We report the case of a 10-year-old girl who received a cadaveric kidney transplant for oxalosis after a period of 12 months on hemodialysis. The donor was a 6-year-old child. Cold ischemia was four hours. Diuresis occurred immediately in the operating room. Mean daily diuresis was maintained at 8 liters: first by i.v. perfusion, then by nocturnal continuous nasogastric hydration. In addition to the usual immunosuppressive drugs, she received pyridoxine, sodium citrate, phosphate, hydrochlorothiazide and magnesium. Daily hemodialysis was performed from Day 1 to Day 9 and four additional sessions every other day. The postoperative course was satisfactory. Oxaluria was elevated initially at 1074 mg/24 h (normal < 50 mg/24 h). One year later, mean daily diuresis is still 8 liters, renal function is normal and oxaluria is at 296 mg/24 h. Repeated graft sonography showed no nephrocalcinosis, but mild oxalate deposits are noted on renal biopsy. Isolated renal transplantation was successful in our patient. It allowed us to stop hemodialysis and to avoid extra-renal accumulation of oxalate. Despite this success, we are convinced that long term prognosis is uncertain and liver transplantation should be realized to correct definitely the biochemical defect.
ISSN:0023-9852