Effect of Ethyl Icosapentate on Urinary Calcium Excretion in Calcium Oxalate Stone Formers

Abstract

Buck and co-workers presented the hypothesis that the initiating factor of stone formation triggers the mechanisms for prostaglandin synthesis, resulting in the biochemical abnormalities associated with stone disease. In order to test this hypothesis, we undertook a clinical study with the use of a highly purified preparation of ethyl icosapentate. Ethyl icosapentate (1,800 mg/day) was administered to 57 patients with urinary stones chiefly composed of calcium oxalate for 6 weeks. Urinary calcium in the hypercalciuric patients reduced significantly, but the calcium level in the normocalciuric group did not decrease. Oxalate values did not reduce either in the hypercalciuric patients or in the normocalciuric subjects. No serious side effects were observed.

Effect of Dietary Intake on Urinary Oxalate Excretion in Calcium Oxalate Stone Formers in Their Forties

“…EPA is reduced in urinary excretion of calcium and oxalate in hypercalciuric stone formers [19]. However, Ito et al [20]reported that administration of EPA to stone formers failed to reduce urinary oxalate excretion. The mechanism of how EPA influences calcium and oxalate excretion remains unknown.…”

Effect of dietary intake on urinary oxalate excretion in calcium renal stone formers

“…Oxalate and calcium were reduced in hypercalciuric recurrent stone formers by enhanced ingestion of fish oil over a period of 8 weeks [17]; these authors suggested that incorporation of eicosapentanoic acid (EPA), a polyunsaturated fatty acid and key substance in prostaglandin synthesis, into the diet was responsible. However, the administration of EPA to stone formers failed to reduce urinary oxalate excretion [18]. Why Eskimos are virtually immune to urolithiasis is still not clear; it may be due to their high consumption of fish oil rich in EPA or low consumption of carbohydrate-rich food which is high in oxalate content.…”

Effect of ethyl icosapentate on urinary calcium and oxalate excretion

“…Ito et al studied EPA‐E to determine its effect on urine chemistries in people who form stones. 20 They found that urinary calcium in hypercalciuric subjects was reduced significantly, but calcium levels in the normocalciuric group did not decrease and oxalic acid values did not decrease in either the hypercalciuric or the normocalciuric subjects.…”

“…From the results of their studies, Buck et al [16][17][18][19] and Ito et al 20 suggested that the incorporation of EPA in the diet could be a unique way of correcting hypercalciuria. We carried out a clinical study with the use of EPA-E in a highly purified form, with the purpose of determining its effect on urine chemistries in people who form calcium-containing stones.…”