Psychological intervention

Kidney

Intensive care medicine

Transplantation

Psychiatry

Primary hyperoxaluria

Liver transplantation

Organic chemistry

Oxalate

Internal medicine

Medicine

Chemistry

Dialysis

Nephrocalcinosis

Nature Reviews Urology

Primary hyperoxalurias are a devastating family of diseases leading to multisystem oxalate deposition, nephrolithiasis, nephrocalcinosis and end-stage renal disease. Traditional treatment paradigms are limited to conservative management, dialysis and combined transplantation of the kidney and liver, of which the liver is the primary source of oxalate production. However, transplantation is associated with many potential complications, including operative risks, graft rejection, post-transplant organ failure, as well as lifelong immunosuppressive medications and their adverse effects. New therapeutics being developed for primary hyperoxalurias take advantage of biochemical knowledge about oxalate synthesis and metabolism, and seek to specifically target these pathways with the goal of decreasing the accumulation and deposition of oxalate in the body.

Perspectives in primary hyperoxaluria — historical, current and future clinical interventions