- Urine volume and change in estimated GFR
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It is to be informed that father and mother of the patient are first cousins and his elder brother at the age of 7 year was died due to kidney failure because of multiple stones in his kidneys.
Patient was diagnosed at the age of 2 year that he has multiple stones in his both kidneys of calcium oxalate. So some stones were removed by lithotripsy process now.
He is 28 year old during this time period number of stones formed and removed through lithotripsy. When stones were analyzed found that it is of calcium oxalate type (35%calcium & 65 % oxalate). As of further details his uric acid was remain 7 to 8. As a remedy he was taking Zyloric due to that it has became normal and his oxalate in 24hr urine were in between 65 to 93 (Normal Range Up to 40).its Important to point out here that his creatinine and urea was remained normal during last 28 years .
Now on 3rd May 2014 his kidneys has been failed their upon doctors advice for kidney transplant his kidney was transplanted on 17 JUNE 2015. After 45 days crystals (calcium Oxalate) were found has been found in the transplanted kidney and oxalate in 24 hr urine is 192 (Normal Range is up to 40)
As he is taking following Medicine right now
1. Bioral 100mg +75mg 1+1
2. Myfortic 1+1+1
3. Fluderm 1+0+0
4. Septran DS 1+0+0 alternate days
5. Urocit-K 2+1+1
6. Vita6 3+3+3
7. Soda Mint 2+2+2
At the moment his creatinine is 6.5 (0.7 to 1.3 mg/dL)- and urea is 100 (7 to 20 mg/dL).
Now questions are as follows
1. What is the reason of the formation of calcium oxalate crystals
2. Reason of Increase of creatinine and urea
3. Intimate its remedy
4. Other tests If required which should be carried out to find out the cause of excessive formation of calcium oxalate crystals
Please suggest the remedy for it to proceed further
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