MO288NEPHROTIC SYNDROME AS A PARANEOPLASTIC ENTITY: ARE WE KEEPING IT IN MIND?

Abstract Background and Aims Association between nephrotic syndrome (NS) and cancer is well known. However, it has been barely studied and scarcely sustained. Membranous nephropathy (MN) has been identified often as a glomerular paraneoplastic disease. Reported incidence of cancer at the time of biopsy or one year follow-up of MN is 10-20%. Incidence rates in other glomerulopathies are limited. Concomitant malignancy is associated with poor renal outcome in NS. Therapy for cancer is priority and immunosuppressives therapies should be restricted. Furthermore, there is no consensus for cancer screening in patients with NS with or without known risk factors for cancer, as smoking or alcohol consumption. The aim of our study is to stablish the incidence of neoplasia in a cohort of patients of a tertiary hospital of Spain who develop NS. We analyze clinical characteristics, glomerular disease, type of malignancies, screening procedures and risk factors for cancer in this population. Method All patients with NS at our center between January 2013 and December 2019 were included. Demographical and clinical data, and laboratory results were collected, as well as all tests performed for cancer screening. Patients who presented cancer the year before or 24 months after the diagnosis of NS were identified. We performed a logistic regression model to identify independent risk factors for cancer in this population. Results During the study period, 47 patients presented with NS at our center. 38.3% were women and mean age was 57.28±17.3 years. 46.8% patients presented high blood pressure and 23.4% type 2 DM. 5 patients presented HIV infection, and 4 hepatitis C. 51% reported smoking, and 19% of alcohol consumption. Mean creatinine at NS diagnosis was 2.48±2.30 mg/dL, and proteinuria 10.9±6.7 g per day. Histologic diagnosis were: MN (n=7), membranoproliferative glomerulonephritis (n=5), diabetic nephropathy (n=5), and focal and segmental glomerulosclerosis (n=4). 9 out 47 patients presented cancer: 6 patients had a malignancy diagnosed the year before the NS onset (prostate carcinoma n=2, gastrointestinal carcinoma n=2, lung carcinoma n=1, and Hodgkin lymphoma n=1), and 3 patients one the year after the NS onset (thyroid carcinoma n=1, melanoma n=1, and multiple myeloma n=1). In the univariate analysis, patients with cancer were older (69.3±12.1 vs 54.4±17.2 years old, p=0.018) and had more frequently alcohol consumption (33.3% vs 15.8%, p=0.0187). There were no differences in terms of smoking, viral infections, renal function, proteinuria or type of glomerulopathy. In multivariate analysis including these two variables and gender, neither age nor alcohol intake were a risk factors for the presence of cancer in patients with NS. Conclusion: 19.1% patients with NS presented also concomitant cancer in our cohort, without association to the type of glomerulopathy, age or known risk factors for neoplasia such as alcohol, tobacco or viral infection. As our data showed, the presence of cancer in patients with NS is considerable, so the development of screening strategies to find occult malignancies in this group of patients is necessary since this condition compromises renal outcome and life expectancy

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Gender Differences in Oesophageal Squamous Cell Carcinoma in a South African Tertiary Hospital

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197086 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7086

Author(s):

Lucien Ferndale ◽

Colleen Aldous ◽

Richard Hift ◽

Sandie Thomson

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Risk Factor ◽

Alcohol Consumption ◽

Cell Carcinoma ◽

Squamous Cell ◽

Clinical Presentation ◽

Tertiary Hospital ◽

Oesophageal Squamous Cell Carcinoma ◽

Males And Females

(1) Oesophageal squamous cell carcinoma is common in Africa and has a male preponderance. The gender-based differences in clinical presentation and risk factor exposure are poorly studied in the African context. Our aim was to compare males and females with this disease. We analyzed the differences in clinical features and risk factor exposure between males and females with oesophageal cancer. (2) Data from patients presenting to a tertiary hospital in South Africa with oesophageal squamous cell carcinoma were analyzed. Data collected included patient demographics, clinical presentation, pathology and risk factor exposure. (3) Three hundred and sixty three patients were included in the study. The male to female ratio was 1.4:1. The mean age was 66 years for females and 61 years for males (p < 0.0001). A significantly larger percentage of males were underweight compared to females (60% vs. 32%, p < 0.001). There were no differences between the genders with regards to performance status, dysphagia grade and duration and tumor length, location and degree of differentiation. There were significant differences between risk factor exposure between the two genders. Smoking and alcohol consumption was an association in more than 70% of males but in less than 10% of females There was no difference survival. (4) Female patients with oesophageal squamous cell carcinoma (OSCC) are older and have a higher body mass index (BMI) than their male counterparts. Traditionally purported risk factors of smoking and alcohol consumption are infrequent associations with OSCC in female patients and other environmental risk factors may be more relevant in this gender.

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Eleven years of children methadone poisoning in a referral center: A review of 453 cases

Journal of Opioid Management ◽

10.5055/jom.2017.0365 ◽

2017 ◽

Vol 13 (1) ◽

pp. 27 ◽

Cited By ~ 7

Author(s):

Hossein Hassanian-Moghaddam, MD, FACMT ◽

Masumeh Hakiminejhad, MD ◽

Fariba Farnaghi, MD ◽

Amirhossein Mirafzal, MD ◽

Nasim Zamani, MD ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Respiratory Failure ◽

Hospital Stay ◽

Odds Ratio ◽

Univariate Analysis ◽

Tertiary Hospital ◽

Alanine Transaminase ◽

Qtc Interval ◽

Great Caution

Objectives: Methadone can be fatal due to respiratory failure even in little doses. This study aimed to evaluate the possible risk factors of death and/or intubation in methadone-poisoned children of 12 years or younger. Design: Retrospective routine database study.Setting: The only tertiary hospital for children poisoning in Tehran.Patients: Four hundred fifty-three methadone-poisoned patients aged 12 or younger were studied between 2001 and 2012.Main Outcome Measures: In-hospital mortality and intubation/mechanical ventilation.Results: Of a total of 475 children included, 22 were excluded due to coingestion of other drugs. Three (0.66 percent) expired and 12 (2.65 percent) were intubated during the course of hospital stay. Intubation (p < 0.001), fever (T axillary ≥ 37.5 °C, p = 0.01), being unresponsive at presentation (p = 0.02), tachycardia (p = 0.01), acidosis (p = 0.03), leukocytosis (p = 0.02), and longer hospital stay (p = 0.01) associated with death. Mortality (p < 0.001), fever (p = 0.004), aspartate aminotransferase (AST; p = 0.006), alanine transaminase (p = 0.04), creatinine (p = 0.005), corrected QT (QTc) interval in triage electrocardiogram (p = 0.02), and longer hospital stay (p = 0.005) associated with intubation in univariate analysis. However, after running regression analysis, only fever, QTc ≥ 480 ms, tachycardia, and AST independently associated with intubation and death. Axillary T ≥ 37.45 °C with an accuracy of 91.9 (95% confidence interval [CI] 88.8-94.2) and odds ratio of 9.3 (95% CI 2.5-34.9) predicted intubation, and T ≥ 37.75 with an accuracy of 96.0 (95% CI 93.5-97.5) and odds ratio of 47.4 (95% CI 4.1-550.1) predicted death. Conclusion: A methadone-poisoned child presenting with tachycardia, fever, abnormal AST, or an initial prolonged QTc interval should be managed with great caution.

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NATURAL HISTORY OF BRAIN ARTERIOVENOUS MALFORMATIONS

Neurosurgery ◽

10.1227/01.neu.0000330401.82582.5e ◽

2008 ◽

Vol 63 (5) ◽

pp. 823-831 ◽

Cited By ~ 289

Author(s):

Juha A. Hernesniemi ◽

Reza Dashti ◽

Seppo Juvela ◽

Kristjan Väärt ◽

Mika Niemelä ◽

...

Keyword(s):

Risk Factors ◽

Arteriovenous Malformations ◽

Univariate Analysis ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Follow Up Study ◽

Brain Arteriovenous Malformations ◽

Long Term Follow Up

Abstract OBJECTIVE Long-term follow-up studies in patients with brain arteriovenous malformations (AVM) have yielded contradictory results regarding both risk factors for rupture and annual rupture rate. We performed a long-term follow-up study in an unselected, consecutive patient population with AVMs admitted to the Department of Neurosurgery at Helsinki University Central Hospital between 1942 and 2005. METHODS Patients with untreated AVMs were followed from admission until death, occurrence of AVM rupture, initiation of treatment, or until the end of 2005. Patients with at least 1 month of follow-up were included in further analysis. Annual and cumulative incidence rates of AVM rupture as well as several potential risk factors for rupture were analyzed using Kaplan-Meier life table analyses and Cox proportional hazards regression models. RESULTS We identified 238 patients with a mean follow-up period of 13.5 years (range, 1 month–53.1 years). The average annual risk of hemorrhage from AVMs was 2.4%. The risk was highest during the first 5 years after diagnosis, decreasing thereafter. Risk factors predicting subsequent AVM hemorrhage in univariate analysis were young age, previous rupture, deep and infratentorial locations, and exclusively deep venous drainage. Previous rupture, large AVM size, and infratentorial and deep locations were independent risk factors according to multivariate models. CONCLUSION According to this long-term follow-up study, AVMs with previous rupture and large size, as well as with infratentorial and deep locations have the highest risk of subsequent hemorrhage. This risk is highest during the first few years after diagnosis but remains significant for decades.

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Risk Factors for Recurrence of Right Colonic Diverticulitis

Digestive Surgery ◽

10.1159/000494297 ◽

2018 ◽

Vol 36 (6) ◽

pp. 509-513 ◽

Cited By ~ 3

Author(s):

Yeong-Chan Kim ◽

Jun-Won Chung ◽

Jeong-Heum Baek ◽

Won-Suk Lee ◽

Doojin Kim ◽

...

Keyword(s):

Risk Factors ◽

Alcohol Consumption ◽

Hospital Stay ◽

Recurrence Rate ◽

Large Scale ◽

Univariate Analysis ◽

High Recurrence Rate ◽

Time Interval ◽

Colonic Diverticulitis ◽

Risk Factors For Recurrence

Background: Right colonic diverticulitis (RCD) is more common in Asian countries than in Western countries, and the risk factors for recurrence of RCD are not fully understood. The objective of this study was to assess the risk factors for recurrence of RCD. Methods: We analyzed 296 patients admitted for treatment of RCD in the Gachon University Gil Medical Center from December 2001 to October 2014. Gender, age, BMI, obesity, hypertension, diabetes mellitus, alcohol consumption, smoking, Hinchey classification, and hospital stay were investigated as risk factors for recurrence. Results: Of the 296 patients with RCD, 31 patients recurred after conservative treatment. The median time interval between the initial episode and recurrence of diverticulitis was 10.4 months. In the univariate analysis, a high recurrence rate was observed in patients with a history of alcohol consumption, smoking, and long hospital stay. In the multivariate analysis, the recurrence rate was much higher (p < 0.001) in patients who stayed in the hospital for more than 10 days after the first attack. Smoking also elevated the recurrence rate (p = 0.011). Conclusion: Factors associated with recurrence of RCD may include smoking and the long hospital stay due to complexity when first diverticulitis occurs. Further prospective large-scale studies are needed to draw a definite conclusion.

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Impact of Obesity and Heavy Alcohol Consumption on Hepatocellular Carcinoma Development after HCV Eradication with Antivirals

Liver Cancer ◽

10.1159/000513705 ◽

2021 ◽

pp. 1-11

Author(s):

Tatsuya Minami ◽

Ryosuke Tateishi ◽

Naoto Fujiwara ◽

Ryo Nakagomi ◽

Takuma Nakatsuka ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Alcohol Consumption ◽

Chronic Hepatitis C ◽

Incidence Rates ◽

Multicenter Cohort Study ◽

Heavy Alcohol ◽

Heavy Alcohol Consumption

Background and Aims: It remains unclear whether obesity increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C who achieved a sustained virological response (SVR) with antiviral therapy. Methods: In this multicenter cohort study, we enrolled patients with chronic hepatitis C who achieved SVR with interferon (IFN)-based therapy (IFN group) or direct-acting antiviral (DAA) therapy (DAA group) between January 1, 1990, and December 31, 2018. The patients underwent regular surveillance for HCC. Cumulative incidence of and the risk factors for HCC development after SVR were assessed using the Kaplan-Meier method and Cox proportional hazard regression analysis, respectively. Results: Among 2,055 patients (840 in the IFN group and 1,215 in the DAA group), 75 developed HCC (41 in the IFN group and 34 in the DAA group) during the mean observation period of 4.1 years. The incidence rates of HCC at 1, 2, and 3 years were 1.2, 1.9, and 3.0%, respectively. Multivariate analysis revealed that in addition to older age, lower albumin level, lower platelet count, higher alpha-fetoprotein level, and absence of dyslipidemia, obesity (body mass index ≥25 kg/m2) and heavy alcohol consumption (≥60 g/day) were independent risk factors for HCC development, with adjusted hazard ratio (HR) of 2.53 (95% confidence interval [CI]: 1.51–4.25) and 2.56 (95% CI: 1.14–5.75), respectively. The adjusted HR was not significant between the 2 groups (DAA vs. IFN; HR 1.19, 95% CI: 0.61–2.33). Conclusions: Obesity and heavy alcohol consumption increased the risk of HCC development after SVR.

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649 Incidence of thromboembolism (TE) in patients with melanoma receiving immune checkpoint inhibitor (ICI) therapy and its adverse impact on survival

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-sitc2020.0649 ◽

2020 ◽

Vol 8 (Suppl 3) ◽

pp. A687-A687

Author(s):

Tamara Sussman ◽

Joanna Roopkumar ◽

Hong Li ◽

Keith McCrae ◽

Pauline Funchain ◽

...

Keyword(s):

Risk Factors ◽

Cumulative Incidence ◽

Univariate Analysis ◽

Single Agent ◽

Cleveland Clinic ◽

Stage Iv ◽

Incidence Rates ◽

Rank Test ◽

Vein Thrombosis ◽

Stage Iv Disease

BackgroundLittle is known about rates of arterial thromboembolism (ATE) and venous thromboembolism (VTE) in patients with melanoma on ICI. We assessed incidence and outcomes of ATE and VTE in patients with melanoma receiving ICI.MethodsWe conducted a retrospective cohort study of patients with melanoma receiving ICI from July 2015 through December 2017 at Cleveland Clinic. TE including VTE events of deep venous thrombosis (DVT), pulmonary embolism (PE), visceral vein thrombosis (VVT), and ATE events of myocardial infarction (MI), stroke, or transient ischemic attack (TIA) after ICI initiation were identified. Overall survival (OS) from ICI initiation was estimated by Kaplan-Meier and Cox hazard models; associations between TE, ICI regimen, and clinical risk factors were evaluated using log-rank test.ResultsThe study population comprised 228 patients with median age 65 (23–91) years, 67% male, and median follow up 27.3 months. Pembrolizumab was most commonly used (38.7%), followed by combination ipilimumab plus nivolumab (29.4%), ipilimumab (20%), and nivolumab (12.3%). Most had stage IV disease (81.1%) and 11% had brain metastases (BM) at treatment initiation. Fifty-one TE events occurred in 47 patients (20.6%), including 37 (16.2%) VTE and 14 (6.1%) ATE. Of VTE, DVT comprised 46.0%, PE 24.3%, DVT+PE 21.6%, VVT 5.4%, and DVT+VVT 2.7%. Of ATE, stroke comprised 57.2%, MI 35.7%, and TIA 7.1%. Of all TE events, 72% resulted in hospitalization and 19% resulted in clot-related mortality. Cumulative incidence of TE after ICI initiation was 9.3% (95%CI,6.0–13.6%) at 6 months, and 16.0% (95%CI,11.6–21.2%) at 12 months. The 6- and 12-month VTE cumulative incidence rates were 8.0% (95%CI,4.9–12.0%), and 12.9% (95%CI,8.9–17.7%), respectively. The 6- and 12-month ATE cumulative incidence rates were 2.2% (95%CI,0.84–4.8%), and 4.5% (95%CI,2.3–7.8%), respectively. The 6- and 12-month VTE cumulative incidence rates were higher with combination ICI than single agent (16.7% vs. 5.0% and 21.3% vs. 9.5%, respectively; p=0.02) (figure 1). Risk factors associated with VTE in univariate analysis included BM, stage IV disease, combination ICI, and Khorana score ≥1 (p<0.05 for all). In multivariate analysis, combination ICI (HR 2.21; [95%CI,1.04–4.72]; p=0.04) and Khorana score ≥1 (HR 2.48; [95%CI,1.18–5.20]; p=0.02) remained significantly associated with VTE.Of patients without BM, OS was worse in patients with TE compared to those without (3-year OS 34.9% vs. 62.9%; HR 1.84; [95%CI,1.16–2.93]; p<0.001), when adjusted for age, stage, and Khorana score (figure 2).Abstract 649 Figure 1Cumulative incidence of VTE, stratified by ICI*Death before VTE was considered a competing risk in CIF estimationAbstract 649 Figure 2OS in patients without BM stratified by TE statusConclusionsICI is associated with a high incidence of TE in patients with melanoma; TE is associated with substantial worsening of survival.

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Preoperative anthropomorphic and nutritious status and fistula risk score for predicting clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy

10.21203/rs.2.19421/v3 ◽

2020 ◽

Author(s):

Tomoyuki Abe ◽

Hironobu Amano ◽

Tsuyoshi Kobayashi ◽

Keiji Hanada ◽

Minoru Hattori ◽

...

Keyword(s):

Risk Factors ◽

Adipose Tissue ◽

Pancreatic Fistula ◽

Risk Score ◽

Univariate Analysis ◽

Incidence Rates ◽

Postoperative Pancreatic Fistula ◽

Skeletal Mass ◽

Tissue Area ◽

Fistula Risk Score

Abstract Background: The aim of this study was to evaluate the efficacy of the combination of fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD).Methods: In this study, 136 consecutive patients who underwent PD between 2006 and 2018 were enrolled. The risk factors of CR-POPF (grades B and C) were analyzed. Preoperative visceral adipose tissue area (VATA), skeletal mass index (SMI), and subcutaneous adipose tissue area (SATA) were calculated from computed tomography data.Results: The overall 30-day mortality and morbidity rates were 0.7% and 38%, respectively. The incidence rates of grade B and C CR-POPF were 27% and 4%, respectively. A univariate analysis revealed that male sex, habitual smoking, prognostic nutritional index (PNI) < 45, VATA ≥ 90, VATA/SATA ≥ 0.9, VATA/SMI ≥ 1.4, and FRS > 4 were significantly associated with the incidence of CR-POPF. A multivariate analysis revealed that PNI < 45, VATA/SMI ≥ 1.4 and FRS > 4 were the independent risk factors of CR-POPF. A modified prediction score using the combination of VATA/SMI and FRS significantly predicted CR-POPF after PD.Conclusions: Preoperative anthropomorphic imbalance, PNI, and FRS were equally accurate in predicting CR-POPF. Patients with high-risk factors should be closely monitored during the postoperative period.

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CLINICAL CHARACTERIZATION OF PATIENTS WITH DELIRIUM

10.5327/1980-5764.rpda081 ◽

2021 ◽

Author(s):

Giulia Cenci ◽

Daniel Lima Varela ◽

Fábio Pacheco Martins ◽

Caroline Calice da Silva

Keyword(s):

Risk Factors ◽

Medical Records ◽

Associated Factors ◽

Tertiary Hospital ◽

Incidence Rates ◽

Targeted Prevention ◽

Prevention Strategies ◽

Clinical Conditions ◽

Reason For Admission

Background: Considering that Delirium is a very common neuropsychiatric disorder, it is very important that the characteristics and clinical evolution of patients who develop the condition are thoroughly known. Objective: Describe the clinical profile of patients with Delirium in order to help in the discernment of the most prevalent risk factors and the characteristics of involvement of Delirium. Methods: Descriptive, quantitative and prospective study, which analyzed epidemiological and medical history data, collected through interviews and data from medical records in a tertiary hospital, from March to June 2021. Results: The sample consisted of 5 individuals, with a mean age of 74.2 years, with a predominance of males. All of them had previous comorbidities and forty percent had previous dementia. Among the interviewees, only one presented the development of the Delirium condition as a reason for admission, the majority (80%) was hospitalized for other clinical conditions and developed Delirium only after admission. It was observed that a large part of the sample (60%) was in polypharmacy, and the only individuals with Delirium under 60 years old used 5 or more medications and had HIV infection. Conclusion: The most effective way to reduce the incidence rates of Delirium, improve the prognosis and assist in early diagnosis is through the recognition of associated factors and the characteristics of the most affected population, in order to identify individuals at risk and be able to promote more targeted prevention strategies.

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Incidence and risk factors of oroantral perforation following tooth ex- traction among Nigerian population in a tertiary hospital: a ten- year retrospective study

Iraqi Dental Journal ◽

10.46466/idj.v41i1.177 ◽

2019 ◽

Vol 41 (1) ◽

Author(s):

Ekaniyere Benlance ◽

Birch Dauda SAHEEB

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Univariate Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Tertiary Hospital ◽

Outcome Variable ◽

P Value ◽

Posterior Teeth ◽

Nigerian Population

Oro-antral perforation (OAP) could be misdiagnosed if the incidence and risk factors are unknown and its consequence could be worrisome. We aimed to determine the incidence and risk factors of oro-antral perforations after teeth extraction. A retrospective study of forceps extracted upper posterior teeth over a ten-year period from September 2008 to November 2018 was done at our hospital in Nigeria. In univariate analysis, the predictors were age, gender, experience of surgeon, site of tooth, side of surgery, use of elevators while the outcome variable was oroantral perforations. Logistic regression was also done to determine the risk factors associated OAP. We used SPSS Version 17(SPSS Inc, Chicago, USA) to perform descriptive and inferential statistical analysis. P-Value less than 0.05 was considered statistically significant. Out of the total 26,372 dental extractions during the ten-year period, 54 (0.2%) extraction cases (33 males, 21 females) had oro-antral perforations. Their mean age was 54.8± 10.6years (ranging from 21 to78 years). The highest incidence occurred in the sixth decade of life. Only the location of teeth had a significant association with oro-antral perforations. The location of upper first molar was (OR = 1.85, P=0.00) identified as a significant risk factor. The incidence of OAP is significantly lower in Nigerians and was 0.2% although there could be a population variability. The position of the upper first molar was a factor found to be associated and predictive of the OAP but age, gender, number of extractions per visit, side of operation and the surgeon’s experience were not. The findings will help surgeons to predict occurrence of OAP knowing its risk factors.

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Clinical Outcomes and Histological Patterns in Oxalate Nephropathy due to Enteric and Nonenteric Risk Factors

American Journal of Nephrology ◽

10.1159/000520286 ◽

2021 ◽

Vol 52 (12) ◽

pp. 961-968

Author(s):

Swetha Reddy ◽

Erin Bolen ◽

Mina Abdelmalek ◽

John C. Lieske ◽

Maggie Ryan ◽

...

Keyword(s):

Risk Factors ◽

Current Knowledge ◽

Univariate Analysis ◽

Case Series ◽

Renal Outcome ◽

Data Repository ◽

Renal Outcomes ◽

Interstitial Inflammation ◽

Enteric Group ◽

Oxalate Nephropathy

Introduction: Current knowledge of risk factors and renal histologic patterns of oxalate nephropathy (ON) not due to primary hyperoxaluria (PH) has been limited to small case series and case reports. Thus, we analyzed and compared clinical risk factors, histologic characteristics, and renal outcomes of patients with biopsy-confirmed ON among a cohort of patients with enteric and nonenteric risk factors. Methods: A clinical data repository of native kidney pathology reports from 2009 to 2020 at all Mayo Clinic sites was used to identify 421 ON cases. Results: After excluding cases in transplanted kidneys or due to PH, 64 cases remained. Enteric risk factors were present in 30 and nonenteric in 34. Roux-en-Y gastric bypass (17) and pancreatic insufficiency (6) were most common in the enteric hyperoxaluria group. In the nonenteric group, vitamin C (7) and dietary oxalate (7) were common, while no apparent risk was noted in 16. Acute kidney injury (AKI) stage III at the time of diagnosis was present in 60%, and 40.6% required dialysis. Patients in the nonenteric group had more interstitial inflammation (p = 0.01), and a greater number of tubules contained intratubular calcium oxalate (CaOx) crystals (p = 0.001) than the nonenteric group. Patients in the enteric group were more likely to have baseline chronic kidney disease (CKD) (p = 0.02) and moderate-to-severe tubulointerstitial fibrosis and atrophy (IFTA) (OR 3.49, p = 0.02). After a median follow-up of 10 months, 39% were dialysis dependent, 11% received a kidney transplant, and 32% died. On univariate analysis, >10 tubules with CaOx crystals, baseline CKD, and AKI requiring dialysis correlated with the risk of dialysis, transplant, or death. On multivariate analysis, only AKI requiring dialysis correlated with adverse renal outcomes. Conclusion: This is the largest cohort study of ON not due to PH. Histologic features differ in patients with enteric versus nonenteric risks. Patients in the enteric group are more likely to have baseline CKD and significant IFTA, while patients in the nonenteric group were more likely to have a greater number of tubules with CaOx crystals and corresponding interstitial inflammation. AKI requiring dialysis at the time of diagnosis was the single most significant predictor of adverse renal outcome.

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