Case Review Stone in Young Age

18 year male with history of recurrent calcium oxalate stone presented with

Nausea, vomiting and pruritis.

On examination : He had pale conjuctiva, trace limb edema and normal prssures.

Lab shows:

Urea 70 mg/dl.  S . Creatinine 5.1 mg/dl.

Hco3 18 ;  Ca 8.2;  Po4 7.0;

Ultrasound shows normal size kidney with multiple concretions bilatteally and

No obstruction seen.

24 hours urinary protein excretion 350mg.

Q: what is the aetiology of renal failure and what is the treatment?

Answere: 

The likely diagnosis is Hyperoxalurea.

High urine out put should be maintained. Avoid oxalate rich foods.

Some patients with primary hyperoxalurea respond to high dose pyridoxine.

Oral citrated may be of benefit. Once renal failure develops , patients with Primary hyperoxalurea

Should be advised of liver and kidney both transplantaion.