Nocturnal home hemodialysis for a patient with type 1 hyperoxaluria

Troy J Plumb, Melissa L. Swee, Jennifer A Fillaus

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Type 1 primary hyperoxaluria is a genetic disorder caused by deficiency of the liver-specific peroxisomal enzyme alanine-glyoxylate aminotransferase. This enzyme deficiency leads to excess oxalate production and deposition of calcium oxalate salts, resulting in kidney failure and systemic oxalosis. Aside from combined liver/kidney transplantation, no curative treatment exists. Various strategies for optimizing dialysis treatment have been evaluated, but neither conventional hemodialysis nor peritoneal dialysis can keep pace with oxalate production in this patient population. In this report, we describe a patient with end-stage renal disease from type 1 primary hyperoxaluria managed with nocturnal home hemodialysis. Performing hemodialysis 8-10 hours each night with blood flow of 350 mL/min and total dialysate volume of 60 L, she has maintained pre- and postdialysis serum oxalate levels at or below the level of supersaturation. We also review published literature regarding oxalate removal in various modalities of dialysis in patients with type 1 primary hyperoxaluria. In our patient, nocturnal hemodialysis has controlled serum oxalate levels better than conventional hemodialysis therapies. Home nocturnal hemodialysis should be considered an option for management of patients with end-stage renal disease from type 1 hyperoxaluria who are awaiting transplantation.

Original languageEnglish (US)
Pages (from-to)1155-1159
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume62
Issue number6
DOIs
StatePublished - Dec 1 2013

Fingerprint

Home Hemodialysis
Hyperoxaluria
Oxalates
Renal Dialysis
Chronic Kidney Failure
Dialysis
Calcium Oxalate
Inborn Genetic Diseases
Dialysis Solutions
Peritoneal Dialysis
Enzymes
Serum
Liver Transplantation
Kidney Transplantation
Renal Insufficiency
Therapeutics
Salts
Transplantation
Liver
Population

Keywords

  • Primary hyperoxaluria
  • dialysis
  • home hemodialysis
  • oxalate

ASJC Scopus subject areas

  • Nephrology

Cite this

Nocturnal home hemodialysis for a patient with type 1 hyperoxaluria. / Plumb, Troy J; Swee, Melissa L.; Fillaus, Jennifer A.

In: American Journal of Kidney Diseases, Vol. 62, No. 6, 01.12.2013, p. 1155-1159.

Research output: Contribution to journalArticle

Plumb, Troy J ; Swee, Melissa L. ; Fillaus, Jennifer A. / Nocturnal home hemodialysis for a patient with type 1 hyperoxaluria. In: American Journal of Kidney Diseases. 2013 ; Vol. 62, No. 6. pp. 1155-1159.
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