Case Report: Acute oxalate nephropathy due to high vitamin C doses and exocrine pancreatic insufficiency, 2019, Fijen and Weijmer

[Andy]

Oxalate kidney injury can manifest as oxalate nephropathy or nephrolithiasis and present as acute kidney injury or even as end-stage renal disease. There are several known causes for acute oxalate nephropathy; however, the combination of exocrine pancreatic insufficiency with overconsumption of vitamin C has not been described before. In this case, a man in his early 80s presented with anorexia and extreme fatigue for 1 week. He had a history of myalgic encephalomyelitis, also known as chronic fatigue syndrome, for which he took several supplements, including high doses of vitamin C. Furthermore, several years ago, he was diagnosed elsewhere with exocrine pancreatic insufficiency. On admission, acute kidney injury was diagnosed. The kidney biopsy showed oxalate nephropathy as the cause. We diagnosed acute oxalate nephropathy due to high vitamin C doses and exocrine pancreatic insufficiency. Within 14 days, his kidney function got worse and he required renal replacement therapy.

Paywall, https://casereports.bmj.com/content/12/11/e231504
Not available via Scihub at time of posting.

 

[NelliePledge]

Dr Myhill needs to review this and consider her advice about Vitamin C

 

[Sly Saint]

Not just a vitamin C issue

Diet-induced oxalate nephropathy
https://casereports.bmj.com/content/12/9/e231284

 

[Saz94]

Dr Myhill needs to review this and consider her advice about Vitamin C

How much Vitamin C does she advice? 2-4 grams, if my memory serves correctly? And how much was the patient in this case study taking?

 

[NelliePledge]

How much Vitamin C does she advice? 2-4 grams, if my memory serves correctly? And how much was the patient in this case study taking?

Checked before looking website currently says 2-6 g.

he was taking 500mg vit C as well as consuming quite a lot of high oxalate food - different nuts and a litre a day of almond milk

 

[Dolphin]

Case presentation

A man in his early 80s was diagnosed with myalgic encephalomyelitis 27 years ago by an internist. A week before admission, the patient noticed increased fatigue. Furthermore, he developed anorexia and his fluid intake diminished. He had a history of hypertension, complicated by moderate chronic kidney disease with a serum creatinine of 175 μmol/L. Additionally, for approximately 20 years, he had chronic diarrhoea and was diagnosed with exocrine pancreatic insufficiency in another hospital. His medication included 1000–2000mg vitamin C, 10mg amlodipine, 800IU cholecal-ciferol, 100mg ciprofibrate, 2.5mg clonazepam, 15mg hydrocortisone, 500 μg IM hydroxocobal-amin two times per week, 330mg levocarnitine, 150 μg levothyroxine, 25mg liothyronine, 12mg loperamide, 500mg mesalazine, 100mg modafinil, 4 capsules pancreatin, 40mg pantoprazole, 40mg simvastatin and a testosterone gel.

 

[alktipping]

that's a lot of meds how they come to a firm conclusion about vit c being the main culprit is beyond me. but common sense tells me to much of anything is always a bad idea .