Oxalic Acid Lithiasis and the Hyperoxaluric Syndromes

Marangella, Martino; Bruno, M.; Fruttero, B; Linari, F

doi:10.1007/978-1-4684-8944-6_26

Cited by 2 publications

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Normal subjects are able to maintain the oxalate balance by means of a very efficient renal excretion which accounts for virtually all the oxalate losses [1][2][3]. Since the kidney is the main route for oxalate elimination from the body, any reduction in renal function will result in oxalate retention [2,4,5].…”

Section: Introductionmentioning

confidence: 99%

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Marangella¹,

Petrarulo²,

Mandolfo

et al. 1992

Nephron

View full text Add to dashboard Cite

Regular dialysis treatment (RDT) does not obviate hyperoxalemia of chronic renal failure (CRF). However, there is emerging evidence suggesting that current dialysis prescription is not always associated to progressive oxalate accumulation. In view of the controversy still concerning this issue, we have investigated on plasma profiles and dialysis kinetics of oxalate in patients on RDT. Oxalate was determined by ion chromatography on serum ultrafiltrates and on the whole dialyzate in 23 stable patients on RDT for end-stage renal failure unrelated to primary hyperoxaluria. Nine patients were on traditional hemodialysis (HD) and 14 on soft hemodiafiltration (HDF). Dialysis prescription was set so as to obtain similar KT/V of urea. Mean dialyzer clearance of oxalate (Kd_Ox) was calculated by standard procedures and was compared to urea (Kd_Urea) and creatinine (Kd_Cr) clearances. Oxalate removal was measured on the whole spent dialyzate. Distribution volume of oxalate (V_Ox) was estimated by assuming a single-pool model and was used to estimate the oxalate appearance rate (OxAR). Plasma profiles showed that dialysis patients were virtually always hyperoxalemia However, the threshold of supersaturation for calcium oxalate was exceeded in only 13 of 138 (9.4%) assayed ultrafiltrates, 13% on HD and 7.1% on HDF. Dialysis reduced plasma oxalate by more than 60%. There was a postdialysis oxalate rebound averaging 9.6% at 30 min from the end of dialysis. Plasma oxalate predialysis was independent of sex, age and time on dialysis. Kd_Ox was mildly higher on HDF than on HD, and was lower than both Kd_Urea and Kd_Cr, irrespective of the dialysis technique. Estimated V_Ox was 21.5 litres, that is 37.3% of dry body weight, and was quite similar to estimates obtained in normal subjects and in patients with CRF by alternative isotope dilution methods. OxAR averaged 337 ± 69 μmol/24 h and was not different from the daily oxalate excretion assessed in 40 healthy subjects by the same oxalate assay. OxAR was independent of sex, age and body weight and was significantly related to urea generation and protein catabolic rates. From our results we conclude that, unless the metabolic generation of oxalate is increased, current dialysis programs should prevent progressive oxalate accumulation in the majority of the patients.

show abstract

Section: Introductionmentioning

confidence: 99%

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Marangella¹,

Petrarulo²,

Mandolfo

et al. 1992

Nephron

View full text Add to dashboard Cite

show abstract

Hyperoxaluria in Idiopathic Calcium Stone Disease: Further Evidence of Intestinal Hyperabsorption of Oxalate

Marangella¹,

Fruttero²,

Bruno³

et al. 1982

Clinical Science

View full text Add to dashboard Cite

1. Seventeen healthy controls and 63 patients with idiopathic calcium stone disease of the urinary tract were investigated for urinary calcium and oxalate excretion and for [14C]oxalate intestinal absorption. 2. Under comparable controlled dietary intake a significant increase in calcium excretion as found in patients with stone disease. Oxalate excretion and [14C]oxalate intestinal absorption were mildly but not significantly increased. When patients with stone disease were subdivided into normocalciuric and hypercalciuric subjects, oxalate excretion and [14C]oxalate absorption were significantly increased in the latter. There was a significant direct relationship between calcium excretion and both oxalate excretion and [14C]oxalate absorption. 3. [14C]Oxalate absorption increased significantly in 22 stone-formers when dietary calcium was changed from normal to low. 4. The kinetics of [14C]oxalate intestinal absorption showed that the main difference between normocalciuric and hypercalciuric subjects occurred within the first 6 h after the oxalate-labelled meal. 5. These results confirm that mild hyperoxaluria is a frequent feature of idiopathic calcium stone disease even when patients and controls are studied under controlled dietary conditions. Our data are consistent with the hypothesis that hyperoxaluria is secondary to calcium hyperabsorption and is upper intestinal in origin.

show abstract

Oxalic Acid Lithiasis and the Hyperoxaluric Syndromes

Cited by 2 publications

References 11 publications

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Hyperoxaluria in Idiopathic Calcium Stone Disease: Further Evidence of Intestinal Hyperabsorption of Oxalate

Contact Info

Product

Resources

About