Calcium Treatment of Enteric Hyperoxaluria after Jejunoileal Bypass for Morbid Obesity

Hylander, E.; Jarnum, S.; Nielsen, K.

doi:10.3109/00365528009181482

Cited by 53 publications

(21 citation statements)

References 22 publications

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“…Dietary calcium must not be restricted but must be increased. Calcium salts reduce absorption of dietary oxalate in patients with ileal resection or jejunoileal bypass [202][203][204][205][206][207][208][209] . Calciumcontaining organic marine hydrocolloid decreases oxalate absorption without increasing calcium absorption [206] .…”

Section: Renal Stonesmentioning

confidence: 99%

Management of patients with a short bowel

Nightingale

1999

Nutrition

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Section: Renal Stonesmentioning

confidence: 99%

Management of patients with a short bowel

Nightingale

1999

Nutrition

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“…Plasma oxalate concentrations are increased in all patients with end-stage renal failure, regardless of the cause, although not to the extent seen in primary hyperoxaluria (21 ). Individuals with diverse gastrointestinal conditions that cause fat malabsorption often overabsorb oxalate from their diet (22)(23)(24)(25), a condition termed enteric hyperoxaluria. Relatively little is known regarding the range of plasma oxalate concentrations observed in the enteric hyperoxaluric patient group, although oxalosis has been observed in some patients, associated with end-stage renal failure (23,26 ).…”

mentioning

confidence: 99%

Sensitive Spectrophotometric Assay for Plasma Oxalate

et al. 2005

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“…One cannot usually infuse calcium directly into the colon, but oral administration of calcium supplements will increase calcium delivery to the colon since only a fraction will be absorbed. When JI bypass patients were placed on a higher calcium diet (3000 mg versus 800 mg), gastrointestinal absorption of oxalate fell and urinary oxalate levels similarly decreased [39]. Similar findings were documented on a 3000 mg versus 250 mg calcium diet [40].…”

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confidence: 54%

Nephrolithiasis After Bariatric Surgery for Obesity

Lieske

Kumar

Collazo–Clavell

2008

Seminars in Nephrology

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Surgical intervention has become an accepted therapeutic alternative for the patient with medically complicated obesity. Multiple investigators have reported significant and sustained weight loss after bariatric surgery that is associated with improvement of many weight related medical co-morbidities, and statistically-significant decreased overall mortality for surgically-treated as compared to medically-treated subjects. Although the Roux-en-Y Gastric bypass (RYGB) is considered an acceptably safe treatment, an increasing number of patients are being recognized with nephrolithiasis after this, the most common bariatric surgery currently performed. The main risk factor appears to be hyperoxaluria, although low urine volume and citrate concentrations may contribute. The incidence of these urinary risk factors amongst the total post-RYGB population is unknown, but may be more than previously suspected based upon small pilot studies. The etiology of the hyperoxaluria is unknown, but may be related to subtle and seemingly sub clinical fat malabsorption. Clearly, further study is needed, especially to define better treatment options than the standard advice for a low fat, low oxalate diet, and use of calcium as an oxalate binder. Keywords bariatric surgery; enteric hyperoxaluria; nephrolithiasis; obesity; oxalate; Roux-en-Y gastric bypass The Problem of ObesityAs much as 20% of the United States population is currently classified as obese (body mass index (BMI) > 30 kg/m 2 ), including 11.5 million who are morbidly obese (BMI> 40 kg/m 2 ) [1]. Of these, up to 5 million Americans have what is deemed medically-complicated obesity, since they have weight-related co-morbidities such as concurrent diabetes mellitus, hypertension, sleep apnea, or other severe weight-related conditions. Since diet and life style interventions have been disappointing for durable weight loss, increasing numbers of patients choose surgical interventions to treat their illness [2][3][4][5][6][7]. Indeed, most currently performed bariatric procedures result in marked and sustained weight loss, associated with improvements Surgical Options for Obesity TreatmentThe bariatric procedures currently employed promote weight loss via varied mechanisms (Figure 1). Restrictive procedures such as vertical banded gastroplasty (VBG) and laparoscopic adjustable gastric band (LAGB) each limit caloric intake by the physical restriction imposed by the band on dietary intake. The VBG consists of a stapled proximal gastric pouch with a fixed and non-adjustable outlet created by a mesh band or Silastic ring. Although still performed, poor long term outcomes for weight loss and maintenance have led many bariatric surgeons to abandon this procedure [7,18,19]. LAGB consists of two components, a silicone gastric band with an inner inflatable cuff and a reservoir connected by tubing. The band is placed around the gastric cardia to create a 15 mL proximal gastric pouch with an adjustable restrictive outlet connected to the reservoir implanted in the subcutaneou...

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Calcium Treatment of Enteric Hyperoxaluria after Jejunoileal Bypass for Morbid Obesity

Cited by 53 publications

References 22 publications

Management of patients with a short bowel

Management of patients with a short bowel

Sensitive Spectrophotometric Assay for Plasma Oxalate

Nephrolithiasis After Bariatric Surgery for Obesity

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