Lathiya MK, Errabelli P, Roy S, Mareedu N. Severe acute kidney injury due to oxalate crystal induced severe interstitial nephritis: A case report. World J Nephrol 2024; 13(2): 93976 [PMID: 38983760 DOI: 10.5527/wjn.v13.i2.93976]
Corresponding Author of This Article
Maulik K Lathiya, MBBS, Researcher, Department of Emergency Medicine, Mayo Clinic Health System, 1221 Whipple Street, Eau Claire, WI 54703, United States. lathiya2918@gmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Jun 25, 2024; 13(2): 93976 Published online Jun 25, 2024. doi: 10.5527/wjn.v13.i2.93976
Severe acute kidney injury due to oxalate crystal induced severe interstitial nephritis: A case report
Maulik K Lathiya, Praveen Errabelli, Sasmit Roy, Neeharik Mareedu
Maulik K Lathiya, Department of Emergency Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, United States
Praveen Errabelli, Department of Nephrology, Mayo Clinic Health System, Eau Claire, WI 54703, United States
Sasmit Roy, Department of Nephrology, Centra Lynchburg General Hospital, Lynchburg, VA 24551, United States
Neeharik Mareedu, Department of Nephrology, UPMC Western Maryland, Cumberland, MD 21502, United States
Author contributions: Lathiya MK and Errabelli P contributed to the investigation, coordination, writing (original and final draft), reviewing, and editing; Roy S and Mareedu N contributed to the reviewing, and editing.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maulik K Lathiya, MBBS, Researcher, Department of Emergency Medicine, Mayo Clinic Health System, 1221 Whipple Street, Eau Claire, WI 54703, United States. lathiya2918@gmail.com
Received: March 8, 2024 Revised: May 4, 2024 Accepted: May 21, 2024 Published online: June 25, 2024 Processing time: 108 Days and 10.7 Hours
Abstract
BACKGROUND
Acute kidney injury (AKI) due to interstitial nephritis is a known condition primarily attributed to various medications. While medication-induced interstitial nephritis is common, occurrences due to non-pharmacological factors are rare. This report presents a case of severe AKI triggered by intratubular oxalate crystal deposition, leading to interstitial nephritis. The aim is to outline the case and its management, emphasizing the significance of recognizing uncommon causes of interstitial nephritis.
CASE SUMMARY
A 71-year-old female presented with stroke-like symptoms, including weakness, speech difficulties, and cognitive impairment. Chronic hypertension had been managed with hydrochlorothiazide (HCTZ) for over two decades. Upon admission, severe hypokalemia and AKI were noted, prompting discontinuation of HCTZ and initiation of prednisolone for acute interstitial nephritis. Further investigations, including kidney biopsy, confirmed severe acute interstitial nephritis with oxalate crystal deposits as the underlying cause. Despite treatment, initial renal function showed minimal improvement. However, with prednisolone therapy and supportive measures, her condition gradually improved, highlighting the importance of comprehensive management.
CONCLUSION
This case underscores the importance of a thorough diagnostic approach in identifying and addressing uncommon causes of interstitial nephritis. The occurrence of interstitial nephritis due to oxalate crystal deposition, especially without typical risk factors, emphasizes the need for vigilance in clinical practice.
Core Tip: We have submitted a case report detailing a rare instance of acute kidney injury presenting as interstitial nephritis due to oxalate crystal deposition. While cases of thiazide-induced interstitial nephritis are documented, occurrences after 20 years of treatment are uncommon. This underscores the necessity of considering oxalate crystal deposition when evaluating patients on long-term thiazide diuretics without other risk factors for interstitial nephritis, emphasizing the importance of a comprehensive diagnostic approach.
