Oxalate Nephropathy Causing Irreversible Renal Failure After Roux-en-Y Gastric Bypass Surgery

Abstract

Introduction: Oxalate nephropathy after RYGB, albeit rare, has a poor prognosis with a rapid progression to kidney failure. Oxalate nephropathy has many etiologies and is one of the rare causes of renal failure. Case Presentation: A 39-year-old diabetic woman came to our nephrology clinic because of a progressive increase in serum creatinine from 1 to 4.2. She had a history of Roux-en-Y gastric bypass (RYGB) surgery six months earlier. In view of the unexplained progressive increase in creatinine, a kidney biopsy was done. The histological diagnosis of oxalate nephropathy with diabetic nephropathy class 2b was made. Conclusions: Oxalate nephropathy is a rare and most severe renal complication after bariatric surgery that is reported in some patients after jejunoileal bypass and RYGB surgery. Oxalate nephropathy is progressive in nature and has a poor prognosis. In our case, oxalate nephropathy and kidney failure occurred six months after RYGB surgery. Since the histological finding in our patient revealed oxalate nephropathy with diabetic nephropathy class 2b, it seems diabetic nephropathy can probably facilitate calcium oxalate crystals formation. This important point should be considered that oxalate nephropathy could rapidly progress to renal failure; so, patients who undergo Roux-en-Y gastric bypass surgery should have regular follow-ups.

A Friend or a Foe? Bariatric Surgery in Chronic Kidney Disease: A Case Report

“…Oxalate nephropathy post-RYGB is associated with a dismal prognosis, with 72.7% progressing to end stage renal disease within 3 months [ 6 , 7 ]. In our case, patient presented 6 months post-surgery which is similar to a case reported by Yaghoubi et al [ 8 ]. Other renal lesions such as hypertensive glomerulosclerosis, diabetic nephropathy, or obesity-associated focal segmental glomerulosclerosis can coexist in these patients because of underlying coexisting multiple comorbidities [ 7 ].…”