Do you recommend starting pyridoxine in a patient with ESKD secondary to primary hyperoxaluria type 1 who is also on lumasiran for plasma oxalate reduction?  

If the patient has a monoallelic or biallelic pathogenic variant known to be pyridoxine responsive such as G170R, I would definitely maintain them on pyridoxine 5-10 milligrams/kg. For other patients, I would still air on the side of caution and maintain most patients on pyridoxine since the risk be...