Conclusion: PH1 patients often require intensified dialysis-up to six sessions per week-to manage oxalate burden.However, Brazil's public health system (SUS) covers only three weekly sessions, with a fourth allowed in specific cases.This patient received four sessions per week, a frequency likely insufficient to prevent systemic oxalosis.In resource-limited settings, where access to intensive dialysis and liver transplantation is restricted, RNAi therapies like lumasiran offer a promising alternative due to their ease of administration and potential to improve outcomes.Although POx initially declined with lumasiran, levels later rose, suggesting POx alone may not reliably indicate treatment success in patients with systemic oxalosis.This case illustrates the limitations of relying solely on plasma oxalate (POx) to assess treatment efficacy in dialysis patients with systemic oxalosis.The patient received four dialysis sessions per week-above the SUS standard of three, yet still below the intensity often required in PH1.These findings underscore the need for individualized dialysis strategies and support the role of RNAi therapies in mitigating disparities in care delivery.In resourcelimited settings, optimizing treatment outcomes requires not only access to novel therapies but also systemic improvements in dialysis infrastructure.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.
Boitumelo Vusani Mudumela (Wed,) studied this question.