The most common type, primary hyperoxaluria type 1 (PH1), is caused by a deficiency in the liver enzyme alanine-glyoxylate aminotransferase (AGT), leading to the overproduction and excessive urinary excretion of oxalate.<h4>Case presentation</h4>On routine evaluation, the patient presented with deranged renal function and echogenic kidneys. Here, AGXT is linked to primary hyperoxaluria type 1.