Oxalate nephropathy in an elderly patient with newly diagnosed celiac disease – a case report

Abstract

Abstract Oxalate nephropathy has widely been described in gastrointestinal disease,. This is only the second publication of oxalate nephropathy in newly diagnosed celiac disease. A 72-year-old Caucasian male presented to the hospital with abdominal discomfort and acute renal insufficiency with a creatinine of 290 µmol/L. The clinical course, laboratory results and urinalysis was suspect for tubular injury. Renal biopsy showed calcium oxalate depositions. Elevated serum and urine oxalate levels established the diagnosis oxalate nephropathy. The abdominal complaints, with steatorrhea and positive anti-tissue transglutaminase antibodies were diagnosed as celiac disease, which was confirmed after duodenal biopsies. Treatment with prednisone, gluten-free, low oxalate and normal calcium diet, lowered the serum oxalate levels and improved his renal function. Decreased absorption of free fatty acids can lead to increased free oxalate in the colon, due to the binding of free fatty acids to calcium, preventing the formation of the less absorbable calcium oxalate in the colon. Oxalate dispositions in the kidney can lead to acute tubular injury and chronic renal insufficiency. Celiac disease is therefore one of the intestinal diseases that can lead to hyperoxaluria and oxalate nephropathy.