This biopsy is from a patient with metabolic acidosis, a CPK of 8000 mg/dl a creatinine of 22 mg/dl on admission. The H&E stained section shows birefrigent bluish crystals consistent with calcium oxalate crystals on a background of acute tubular injury. The extensive number of intratubular crystals associated with acute tubular injury support renal oxalosis as the cause of the renal failure. (H&E with polarized light, 200x)
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