Hyperoxaluric calcium nephrolithiasis

Primary and secondary hyperoxaluria: Understanding the enigma

“…In PH patients with ESRD, plasma oxalate levels are typically higher than 80 μmol/ L while in non PH hyperoxaluric patients, the plasma oxalate level may range between 3080 μmol/L [6466] . This is in contrast to plasma oxalate levels of 15 μmol/L in normal subjects [1] . Noninvasive, definitive diagnosis of PH is provided by testing of AGXT, GRHPR and HOGA1 genes.…”

“…Oxalate is abundantly found in plant and animal sources. Dietary sources richest in oxalate include nuts, plums, chocolate, beetroot, strawberries, rhubarb, tofu and spinach [1,7] . Juicing is a recent popular trend where a diet based mainly on fruits and vegetable juices is consumed and may supply a very high amount of daily oxalate [8,9] .…”

Orlistat and calcium oxalate crystalluria: An association that needs consideration

“…12 The likely mechanism of hyperoxaluria with administration of gastrointestinal lipase inhibitors may be because of increased colonic hyperabsorption of oxalate. This may be because of presence of unabsorbed fat and bile acids in the lumen, which may react with calcium and ultimately increase enteric oxalate absorption and hyperoxaluria.…”

“…Furthermore, the presence of free fatty acids in lumen have been shown not only to increase permeability for oxalate but also to increase concentration of soluble oxalate. 12,13 Importantly, administration of orlistat is being shown to be associate not only with significant hyperoxaluria in human and animal models but also with significant increase in the risk of oxalate nephropathy. Ferraz et al showed that in 39 male adult Wistar rats, the use of orlistat, especially under a diet rich in oxalate alone or associated with fat, leads to a significant and marked increase in urinary oxalate and a slight reduction in urinary calcium and urinary magnesium and ultimately increase the risk of urinary saturation of calcium oxalate.…”

Effect of astaxanthin on ethylene glycol induced nephrolithiasis

“…Calcium containing stones especially calcium oxy monohydrate (COM) are the most commonly occurring ones to the extent of 75-90% [1]. Several invasive and non invasive procedures are currently employed for the treatment of kidney stones but they are limited by their high cost, severe adverse effects and high recurrence rates [2].…”