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Improving a Rare Metabolic Disorder Through Kidney Transplantation: A Case Report of a Patient With Lysinuric Protein Intolerance.

Abstract
Lysinuric protein intolerance (LPI) is a rare metabolic disorder with reduced renal and intestinal reabsorption of ornithine, lysine, and arginine. It is due to variants in SLC7A7, the gene encoding y+L amino acid transporter 1 (y+LAT1), which lead to urea cycle defects with protein intolerance. Chronic kidney disease in lysinuric protein intolerance is common and can progress to kidney failure and initiation of kidney replacement therapy. Kidney transplantation could in theory improve urine levels and, consequently, plasma levels of these amino acids and therefore improve clinical symptoms, as well as protein intolerance, in patients with lysinuric protein intolerance. However, data on kidney transplantation in patients with lysinuric protein intolerance are limited, and up until now no data on clinical and biochemical improvement after kidney transplantation have been reported. In this case report we describe a rare case of kidney transplantation in a lysinuric protein intolerance patient with substantial improvement in protein tolerance; in plasma and urine levels of ornithine, lysine, and arginine; and in lysinuric protein intolerance symptoms.
AuthorsTies IJzermans, Wilbert van der Meijden, Marlijn Hoeks, Marleen Huigen, Alexander Rennings, Tom Nijenhuis
JournalAmerican journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 81 Issue 4 Pg. 493-496 (04 2023) ISSN: 1523-6838 [Electronic] United States
PMID36223829 (Publication Type: Case Reports)
CopyrightCopyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Lysine
  • Arginine
  • Ornithine
  • SLC7A7 protein, human
  • Amino Acid Transport System y+L
Topics
  • Humans
  • Lysine (urine)
  • Kidney Transplantation
  • Amino Acid Metabolism, Inborn Errors (complications, drug therapy, genetics)
  • Metabolic Diseases
  • Arginine (therapeutic use, metabolism)
  • Ornithine (therapeutic use)
  • Amino Acid Transport System y+L

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