Dimethyl Oxalate Exposure Induced Oxalate Nephropathy in Two Patients: An Uncommon Trigger for Acute Kidney Injury

Huang X1,2,3, Ren X1,2,3, Zhang R1,2,3, Zhang C1,2,3, Yuan H4* and Zhou X1,2,3*

1Department of Nephrology, Shanxi Provincial People's Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, China
2Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Fifth Hospital of Shanxi Medical University, China
3Shanxi Provincial Key Laboratory of Kidney Disease, Shanxi Provincial People's Hospital, China
4Department of Nephrology, The First Hospital of Jilin University, Changchun, China

^*Correspondance to: Hang Yuan 

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Abstract:

Dimethyl oxalate, a prevalent petrochemical, plays a crucial role in organic synthesis application. However, intoxication from dimethyl oxalate, although rare, can potentially lead to acute kidney injury or even chronic kidney disease. The challenge lies in the insufficient knowledge its symptoms, diagnosis and treatment. This can cause dimethyl oxalate induced-oxalate nephropathy to yield severe consequence. In the present study, we detailed two cases of oxalate nephropathy induced by dimethyl oxalate exposure. Both patients having worked on repairing chemical equipment over extended hours, primarily exhibited symptoms of nausea and vomiting. Renal biopsy from the second patient demonstrated both moderate acute injury and mild chronic changes. Notably, the biopsy revealed multifocal tubular atrophy, eroded brush borders, and the presence of oxalate crystal deposits with the tubules, due to their birefringence under polarized light. Treatment for both individuals encompassed hemodialysis and a daily 30 mg dose of prednisone, resulting in improved renal function upon discharge. This investigation underscored the paramount importance of early detection and adept intervention to thwart the progression to acute kidney injury from oxalate nephropathy. Physicians must remain vigilant, recognizing that oxalate nephropathy, stemming from exposure to volatile dimethyl oxalate, is an exceedingly rare occurrence.

Keywords:

Dimethyl Oxalate; Oxalate Nephropathy; Acute Kidney Injury

Cite the Article:

Huang X, Ren X, Zhang R, Zhang C, Yuan H, Zhou X. Dimethyl Oxalate Exposure Induced Oxalate Nephropathy in Two Patients: An Uncommon Trigger for Acute Kidney Injury. Ann Clin Case Rep. 2023; 8: 2547.