UNUSUAL CASES OF RENAL FAILURE
WITH CRYSTAL NEPHROPATHY.
Fellow- Pediatric Nephrology ( IPNA, ISPN )
Bai Jerbai Wadia Hospital For children
4 months old female child
Oliguric renal failure with convulsions and
respiratory distress following acute
No response to fluid and furosemide
Referred for further care
IIIrd degree consanguinity
Previous sibling (male) death at 3 mo –
4 kg/ 53 cm ,B wt 2.5 kg
No renal lump, rash, chest- clear
plt 3.5 lac
Na/ K/Cl 13/5.2/105
Urine-alb 2+, 60-80
Urine alb/creat ratio 7.2
USG- RK-5.1 * 1.5 cm
LK-4.7 * 1.8 cm
All tubules distended with oxalate crystals,
few surounded by giant cells
Interstitium- focally fibrotic
Dr Kiran Sathe.
Dr Kumud Mehta.
Jaslok Hospital & Research Centre.
6 yr old muslim girl presented with-
colicky abdominal pain
Short Stature Ht 98 cm, wt 14 kg
Consanguinity 3 rd degree
Died at 7 months with renal failure
H/o cousin- died at 15th day of life with renal
failure requiring peritoneal dialysis.
Chronic Kidney Disease stage 5
(End stage renal disease)
Extensively investigated in infancy in view of
significant family h/o
Diagnosed as Hyperoxaluria.
age Hb creat Ca/p/
5 mo 11.5 0.4 9.7/
19 2+ 5-6 5-6 0.9
12 mo 9.8 0.6 8.1/
10.8 2+ 4-5 15-20 neph
24 mo 8.5 0.7 17 20-
32 mo 7.1 2.6 7.4/
60 mo 8.0 5.0 21 Normal 24 hr urine
<45 mg/1.73 m②
72 mo 7.2 8.7 9.4/
Family counseled about the poor prognosis
and the treatment options.
Renal supportive meds
Severe cardiac dysfunction and pulmonary
1. what are the possible clinical presentations for
hyperoxaluria and oxalosis?
2.When do we suspect it?
3. organ systems which are affected and the
4. how do we diagnose it?
5.Treatment options available?
6.Ideal time to consider-
Combined kidney- liver transplant