Oxalate nephropathy: a review

Rosenstock, Jordan L.; Joab, Tatyana M J; Devita, Maria; Yang, Yihe; Sharma, Purva; Bijol, Vanesa

doi:10.1093/ckj/sfab145

Cited by 33 publications

(71 citation statements)

References 79 publications

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“…The primary findings of this single-institution observational study are that during the COVID-19 pandemic, the rate of supplement-associated secondary oxalate nephropathy (44%) increased significantly above our comparative internal historic cohort as well as the published range of approximately 8 - 20% ( 1 , 5 , 6 ). Ingestion-associated oxalate nephropathy had substantially better kidney outcomes than enteric dysfunction associated oxalate nephropathy, with 89% experiencing improvement in renal function.…”

Section: Discussionmentioning

confidence: 66%

“…Ingestion-associated oxalate nephropathy had substantially better kidney outcomes than enteric dysfunction associated oxalate nephropathy, with 89% experiencing improvement in renal function. In addition to identifying high vitamin C intake ( 1 , 15 , 16 ), a well-known cause of oxalate nephropathy, our series also adds to the limited data on more obscure causes of secondary oxalate nephropathy: mushrooms/mushroom extracts, polyethylene glycol, and those occurring in the renal allograft. As there are often not reliable findings to clinically diagnose oxalate nephropathy, awareness of supplement use and consideration for biopsy in patients with unexplained kidney disease may prove valuable in identifying those with reversible kidney dysfunction.…”

Section: Discussionmentioning

confidence: 88%

“…The associated comparative decrease in secondary oxalate nephropathy due to enteric dysfunction may reflect changes in restrictive weight loss surgery: surgeries in which the small bowel is not bypassed, i.e. sleeve gastrectomy, are increasingly popular and are not associated with the same increased risk of oxalate stone formation ( 1 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

“…Oxalate nephropathy is characterized by deposition of calcium oxalate in tubules, usually accompanied by acute tubular injury and sometimes acute or chronic interstitial inflammation ( 1 ). Such deposition leads to impaired kidney function, and patients present with acute kidney injury (AKI) or AKI on chronic kidney disease (CKD); a substantial proportion of patients require renal replacement therapy and may progress to end stage kidney disease (ESKD) ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…Enteric dysfunction-associated oxalate nephropathy ( 3 , 5 ) is the result of a variety of conditions that all ultimately increase intestinal oxalate absorption. These conditions include intestinal fatty acid malabsorption, inflammation, altered permeability, and antibiotic use or other causes of dysbiosis of oxalate-degrading bacteria such as Oxalobacter formigenes ( 1 , 6 , 7 , 8 ) . In particular, intestinal fatty acid malabsorption – often due to gastric bypass or chronic pancreatitis ( 6 , 9 ) – has been the most commonly reported cause of secondary oxalate nephropathy, comprising 75% of cases in a recent systematic review( 2 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Increased Rates of Supplement-Associated Oxalate Nephropathy During COVID-19 Pandemic

Fong

Wusirika²,

Rueda³

et al. 2022

Kidney International Reports

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Increased Rates of Supplement-Associated Oxalate Nephropathy During COVID-19 Pandemic

Fong

Wusirika²,

Rueda³

et al. 2022

Kidney International Reports

View full text Add to dashboard Cite

Perspectives of vitamin C upregulating regulatory T cells in the era of thrombopoietin receptor agonists for immune thrombocytopenia

Tsao¹

2022

Clinical and Translational Dis

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Background Immune thrombocytopenia (ITP) is a rare disorder involving excessive peripheral destruction of platelets and inadequate bone marrow platelet production due to autoimmune reactions against megakaryocytes. Diagnosis is usually by the exclusion of primary causes; its rarity would only permit trial and error therapy experience. Historically, for ITP, oral ascorbic acid (AA) gave inconsistent results. However, unlike other nutrients, AA is found to have an exceptionally tight intestinal absorption restriction mandating intravenous delivery for any therapeutic purposes. Recently, as there is more pre‐clinical evidence of AA restoring regulatory T cells (Tregs) by robust demethylation, the historical oral route was likely to be the “bottle neck” restricting effective blood levels. During this era of thrombopoietin receptor agonists (TPO‐RAs), planned tapering is often required upon discontinuation but unplanned discontinuations, for example, due to side effects, are more problematic. Moreover, combinations with TPO‐RAs are currently being tried using steroids and rituximab except rituximab is inappropriate during pandemics. Notably, with the indirect (but prognostically relevant) action of TPO‐RAs on Tregs, boosting Treg functions by adding other Treg active agents, for example, steroids or AA, seems appropriate, especially if without added toxicity upon combining. Conclusions With updated pharmacokinetic concepts, it is timely to repeat AA clinical trials for ITP but using intravenous administration. Initially, this may be on compassionate grounds for its probable role as an adjunct to TPO‐RAs for unsuccessful tapering and, especially, for all unplanned discontinuations of TPO‐RAs. Such off‐label usage of AA is justified because of AA's robust pre‐clinical evidence on demethylation and initial clinical experience (despite the inappropriate administrative route). Moreover, moderate intravenous AA dosages have one of the best safety profiles, let alone its eminent affordability. Admittedly, after the initial clinical experience, more systematic trials on AA are required, especially for the most appropriate dosage range and its efficacy as monotherapy.

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