{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T16:49:10Z","timestamp":1773938950924,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,6]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Kidney transplantation (KT) is the preferred treatment for end-stage renal disease, yet post-transplant complications and graft dysfunction remain significant challenges. Oxalate nephropathy, resulting from calcium oxalate crystal deposition due to hyperoxaluria, represents an under-recognised contributor to graft injury. We describe a woman in her 60s with obesity, chronic pancreatitis and type 2 diabetes who underwent KT after dialysis. Post-transplant, she developed recurrent pyelonephritis and impaired graft function. The biopsy revealed oxalate crystal deposits, tubular injury and interstitial nephritis and fibrosis consistent with oxalate nephropathy. Contributing factors included chronic pancreatitis-related malabsorption and high dietary vitamin C intake. Supportive measures, including a low-oxalate diet and hydration, were introduced. This case illustrates the multifactorial nature of allograft dysfunction and highlights the importance of considering oxalate nephropathy in at-risk patients. Early recognition and preventive strategies may help preserve graft function and improve long-term outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-269840","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:30:26Z","timestamp":1773934226000},"page":"e269840","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Oxalate nephropathy in kidney transplant"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9173-5845","authenticated-orcid":false,"given":"Filipa Fonte","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Almada-Seixal, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Almada-Seixal, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Manso","sequence":"additional","affiliation":[{"name":"Pathology Department, Unidade Local de Sa\u00fade de Amadora\/Sintra, Amadora, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Bravo","sequence":"additional","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Almada-Seixal, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"2026031908301851000_19.3.e269840.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03686.x"},{"key":"2026031908301851000_19.3.e269840.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2014.05.004"},{"key":"2026031908301851000_19.3.e269840.3","doi-asserted-by":"crossref","first-page":"2654","DOI":"10.1002\/ehf2.13990","article-title":"Association between central haemodynamics and renal function in advanced heart failure: a nationwide study from Sweden","volume":"9","author":"Bobbio","year":"2022","journal-title":"ESC Heart Fail"},{"key":"2026031908301851000_19.3.e269840.4","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17981"},{"key":"2026031908301851000_19.3.e269840.5","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1038\/s41392-023-01379-7","article-title":"Kidney fibrosis: from mechanisms to therapeutic medicines","volume":"8","author":"Huang","year":"2023","journal-title":"Signal Transduct Target Ther"},{"key":"2026031908301851000_19.3.e269840.6","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007020219"},{"key":"2026031908301851000_19.3.e269840.7","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0000000000000515"},{"key":"2026031908301851000_19.3.e269840.8","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00075.2011"},{"key":"2026031908301851000_19.3.e269840.9","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.kint.2018.01.012","article-title":"Unraveling the mechanisms of obesity-induced hyperoxaluria","volume":"93","author":"Sakhaee","year":"2018","journal-title":"Kidney Int"},{"key":"2026031908301851000_19.3.e269840.10","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1159\/000188014","article-title":"Effect of renal transplantation on serum oxalate and urinary oxalate excretion","volume":"67","author":"Worcester","year":"1994","journal-title":"Nephron"},{"key":"2026031908301851000_19.3.e269840.11","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.ekir.2020.06.021","article-title":"Etiologies, Clinical Features, and Outcome of Oxalate Nephropathy","volume":"5","author":"Buysschaert","year":"2020","journal-title":"Kidney Int Rep"},{"key":"2026031908301851000_19.3.e269840.12","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.mayocp.2023.08.014","article-title":"Clinicopathologic Characteristics, Etiologies, and Outcome of Secondary Oxalate Nephropathy","volume":"99","author":"Nasr","year":"2024","journal-title":"Mayo Clin Proc"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269840","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:30:27Z","timestamp":1773934227000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269840"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,19]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-269840"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269840","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}