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. 2020 Jul 16;5(10):1815–1822. doi: 10.1016/j.ekir.2020.07.008

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© 2020 International Society of Nephrology. Published by Elsevier Inc.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Light microscopy examination of kidney biopsy specimens obtained from patients 1 (a–d) and 2 (e–h). (a,e) Low-power view of kidney biopsy specimens with focus on tubule interstitium; several crystals are in the tubular lumens (hematoxylin and eosin [H&E] stain). (b,f) Same sections as a and c examined under polarized light: several birefringent crystals are visible in the tubular lumina (H&E stain). (c) Diffuse acute tubular injury with flattening of epithelial cell line (arrows) and focal cell detachment with intraluminal sloughing (arrowhead) (periodic acid–Schiff stain; original magnification ×400). (d) Detail of intratubular calcium oxalate crystal (arrow), with translucent appearance (H&E stain; original magnification ×400). (g) Diffuse acute tubular injury with extensive vacuolization of tubular epithelial cells and focal flattening of epithelial line (arrows) (periodic acid–Schiff stain; original magnification ×400). (h) Detail of intratubular calcium oxalate crystal (arrow), with translucent appearance (arrows); moderate mixed interstitial infiltrate in area of initial interstitial fibrosis (H&E stain; original magnification ×400).