# From Smoothies to Dialysis: The Impact of Oxalate Nephropathy

## TL;DR

A man with chronic kidney disease developed severe kidney damage from consuming high-oxalate foods, highlighting the risk of oxalate nephropathy.

## Contribution

This case report highlights oxalate nephropathy as a rare but important cause of kidney failure in patients with chronic kidney disease.

## Key findings

- A renal biopsy confirmed acute tubular injury with calcium oxalate deposits.
- The patient's dietary history revealed regular consumption of high-oxalate foods.
- The patient remains dialysis-dependent despite hemodialysis initiation.

## Abstract

Oxalate nephropathy is a rare cause of acute kidney injury that can lead to end-stage renal disease. This case report describes a 54-year-old male with type 2 diabetes mellitus and chronic kidney disease who presented for a routine clinic follow-up. Laboratory tests revealed significant deterioration in renal function with an unrevealing history and symptoms suggestive of the process. Initial investigations for worsening renal function were inconclusive, prompting a renal biopsy that confirmed acute tubular injury with abundant calcium oxalate deposits. Further investigation into dietary history revealed that the patient regularly consumed high-oxalate foods, such as spinach and kale smoothies, under the impression they were beneficial for his diabetes. Despite the initiation of hemodialysis, the patient did not recover renal function and remains dialysis-dependent. This case underscores the need for a high index of suspicion for oxalate nephropathy in chronic kidney disease patients presenting with unexplained acute kidney injury. Diagnosis is confirmed through renal biopsy and should be considered in patients with relevant dietary histories.