Erythropoietin resistance as a result of oxalosis in bone marrow

Clin Nephrol. 2005 May;63(5):402-4. doi: 10.5414/cnp63402.


Anemia is an important cause of morbidity in patients suffering from chronic renal failure, and erythropoietin is a milestone of anemia treatment. Various factors may cause erythropoietin resistance. Herein, we describe the case of 32-year-old man who presented with anemia and weakness. He developed progressive renal failure secondary to recurrent kidney stones. One year before admission, he developed anemia for which he had been treated with erythropoietin. However, the anemia persisted. Examination of bone marrow biopsy specimen showed that the marrow was extensively replaced with oxalate crystals and fibrous connective tissue with severe decrease of hematopoietic cells. To the best of our knowledge, our patient represents the first case in the literature describing the association between the oxalate deposition and EPO resistance.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia / drug therapy*
  • Anemia / etiology*
  • Anemia / physiopathology
  • Biopsy, Needle
  • Bone Marrow Diseases / pathology*
  • Chronic Disease
  • Drug Resistance
  • Erythropoietin / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Hyperoxaluria / complications
  • Hyperoxaluria / diagnosis*
  • Immunohistochemistry
  • Kidney Calculi / complications
  • Kidney Calculi / diagnosis
  • Kidney Calculi / surgery
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / diagnosis*
  • Kidney Failure, Chronic / therapy
  • Male
  • Oxalates / metabolism
  • Renal Dialysis / methods
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Failure


  • Oxalates
  • Erythropoietin