#6180 OXALATE NEPHROPATHY SECONDARY TO ENTERIC HYPEROXALURIA: A RARE CAUSE OF END STAGE RENAL FAILURE – A REPORT OF 2 CASES

Abstract Background and Aims Oxalate nephropathy is a rare cause of renal failure which usually due to primary or secondary hyperoxaluria. Secondary hyperoxaluria results from increased intake intestinal oxalate availability (enteric hyperoxaluria), degradation, colonic permeability [1]. Little known about the burden end stage kidney disease in this group patients as most initial literature was case reports series. More recently, prevalence 1- 4.01% reported biopsy studies suggesting that entity indeed needs be considered [2,3]. Method We present two cases enteric following small bowel resections. Results CASE ONE 82 year old man with solitary who admitted ED on account decline function background episodes loose stools. This his second admission months function. He had emergency laparotomy adhesiolysis result obstruction volvulus 12 earlier. Other past medical history include left nephroureterectomy for cancer, transurethral resection bladder tumour, hypertension, Barretts appendectomy. His medications were Omeprazole(which switched Famotidine hypomagnesaemia 7 postop), Atenolol Adcal D3. Renal immunology myeloma screen negative. Urine bland ultrasound did not show any obstruction. AKI initially thought pre-renal there some improvement fluids during first although didn't return baseline. progressively worsened spate few months. baseline creatinine 130 prior 184 post surgery bur improved 109 days op. However, noticed 9 op eventually peaked at 751, fourteen 13 showed oxalosis, acute tubular injury patchy interstitial fibrosis. continued deteriorate he commenced haemodialysis. TWO A 75-year-old referred clinic Crohn's disease, previous right hemicolectomy 26 years ago revision 4 ago, ileostomy(with subsequent reversal), inguinal herniorrhaphy, hypertension BPH. Azathioprine attributable Azathioprine. include: Amlodipine 5 mg, Finasteride Loperamide 2 mg bd, Tamsulosin 400mcg od. At referral, deteriorated over 145 303, 44 after last surgery. Urinalysis trace protein + blood however, urine ACR normal. Vasculitis also Ultrasound ruled out Despite pausing Azathioprine, peaking 561 next subsequently chronic damage casts. Conclusion These highlight need consider presenting unexplained have risk factors fat malabsorption. important usual poor prognosis