Diet-induced oxalate nephropathy

BMJ Case Rep. 2019 Sep 16;12(9):e231284. doi: 10.1136/bcr-2019-231284.


Oxalate nephropathy is a rare condition and may be overlooked due to lack of recognition and understanding of triggers. An 81-year-old man was sent to nephrologist because of significantly increased creatinine (1.5-1.9 mg/dL) noted for 3 months. He had well-controlled diabetes but no history of kidney disease. He had no chronic diarrhoea or intestinal surgery. He was a health-minded individual who had read extensively about benefit of antioxidants. Initial work-up was unrevealing. Within a few weeks after first visit, he developed acute symptomatic worsening kidney injury with nausea, vomiting and creatinine up to 6.8 mg/dL. Repeat examination of the urine sediment revealed casts containing calcium oxalate crystals. A deeper dietary history revealed widespread oxalate precursor consumption. A kidney biopsy confirmed oxalate nephropathy. Restriction of oxalate consumption combined with adequate hydration, oral calcium acetate resulted in partial renal recovery without need for haemodialysis.

Keywords: acute renal failure; nutrition; renal system; urinary and genital tract disorders.

Publication types

  • Case Reports

MeSH terms

  • Acetates / therapeutic use*
  • Acute Kidney Injury / drug therapy*
  • Acute Kidney Injury / etiology*
  • Aged, 80 and over
  • Calcium Compounds / therapeutic use
  • Diagnosis, Differential
  • Diet / adverse effects*
  • Humans
  • Male
  • Oxalates / adverse effects*


  • Acetates
  • Calcium Compounds
  • Oxalates
  • calcium acetate