Pyridoxine and Dietary Counseling for the Management of Idiopathic Hyperoxaluria in Stone-forming Patients

Ortiz-Alvarado, Omar; Miyaoka, Ricardo; Kriedberg, Carly; Moeding, Angela; Stessman, Michelle; Monga, Manoj

doi:10.1016/j.urology.2010.08.002

Cited by 47 publications

(24 citation statements)

References 28 publications

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“…B6-deficient rats, 34 and pyridoxine is known to be an effective first-line therapy to decrease hyperoxaluria in patients who develop stones. 16 Ascorbic acid, as well as other radical scavengers, and the antioxidant enzymes decreased in urolithic condition, suggestive of the active involvement of free radical-mediated lipid peroxidation-induced membrane damage in kidney. 35 Vit.…”

Section: Discussionmentioning

confidence: 94%

The efficacy of antioxidant therapy against oxidative stress and androgen rise in ethylene glycol induced nephrolithiasis in Wistar rats

et al. 2014

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Administration of natural antioxidants has been used to protect against nephrolithiasis. Urolithiasis was induced by ethylene glycol (EG) in Wistar rats. For 4 weeks, group 1 (control) was fed with a standard commercial diet. Group 2 received the same diet with 0.75% of EG. Group 3 received EG plus the diet and water added with antioxidant nutrients and lime juice as the dietary source of citrate (EG + AX). Group 4 same as group 3 with no EG in water. For 8 weeks, group 5 was fed the standard diet with EG in water for the first 28 days, followed by no EG. Group 6 received the diet with EG for the first 28 days, followed by discontinuation of EG and addition of antioxidant nutrients. Group 7 were provided the diet with antioxidant nutrients for 8 weeks. Group 8 received the diet with antioxidant nutrients for 4 weeks, followed by antioxidant nutrients with EG for the next 4 weeks. Blood samples were collected and kidneys were removed. The size and the mean number of crystal deposits in EG-treated groups was significantly higher than the EG-treated groups, added with antioxidant nutrients and lime juice. After 4 weeks, the mean concentration of malondialdehyde in group 2 was higher than the group 3, and significantly lower in group 4; and in groups 7 after 8 weeks, as well. After 8 weeks, supplementation developed less mean number of deposits in group 6 as compared to group 5; and in group 8, the crystal deposits was substantially less than either group 2 or group 5 (EG-treated rats). Elevated concentration of androgens (as promoters of the formation of renal calculi) as a result of EG consumption decreased following antioxidant supplementations. Results showed a beneficial effect of antioxidant and provided superior renal protection on treating and preventing stone deposition in the rat kidney.

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Section: Discussionmentioning

confidence: 94%

The efficacy of antioxidant therapy against oxidative stress and androgen rise in ethylene glycol induced nephrolithiasis in Wistar rats

et al. 2014

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“…Large cohort studies have shown an inverse association between pyridoxine intake and the risk of stone formation, 19 and a retrospective study suggested that pyridoxine, combined with dietary modification, can reduce urinary oxalate in hyperoxaluric stone formers. 62 Citrate Urinary citrate inhibits calcium stone formation by complexing with urinary calcium and lowering ionized calcium and by inhibiting calcium oxalate and calcium phosphate crystal growth and aggregation. 63 Renal citrate excretion is modulated primarily by the systemic acid-base balance; acidosis decreases and alkalosis increases renal tubular production and excretion of citrate.…”

Section: Sodiummentioning

confidence: 99%

Medical management of renal stones

Morgan

Pearle

2016

BMJ

117

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The prevalence of kidney stones is increasing in industrialized nations, resulting in a corresponding rise in economic burden. Nephrolithiasis is now recognized as both a chronic and systemic condition, which further underscores the impact of the disease. Diet and environment play an important role in stone disease, presumably by modulating urine composition. Dietary modification as a preventive treatment to decrease lithogenic risk factors and prevent stone recurrence has gained interest because of its potential to be safer and more economical than drug treatment. However, not all abnormalities are likely to be amenable to dietary therapy, and in some cases drugs are necessary to reduce the risk of stone formation. Unfortunately, no new drugs have been developed for stone prevention since the 1980s when potassium citrate was introduced, perhaps because the long observation period needed to demonstrate efficacy discourages investigators from embarking on clinical trials. Nonetheless, effective established treatment regimens are currently available for stone prevention.

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“…However, it has only been demonstrated to be beneficial in certain patients with type 1 primary hyperoxaluria [33]. Its utilization in patients with idiopathic hyperoxaluria has not been substantiated with well-designed studies [34]. In theory, it could benefit such patients as it may promote the activity of alanine glyoxylate aminotransferase, which diverts glyoxylate away from oxalate synthesis or potentially stimulates other aminotransferases.…”

Section: Other Strategies To Lower Urinary Oxalate Excretionmentioning

confidence: 99%

Lowering urinary oxalate excretion to decrease calcium oxalate stone disease

2015

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Dietary modifications should be considered as a first line approach in the treatment of idiopathic calcium oxalate nephrolithiasis. The amounts of oxalate and calcium consumed in the diet are significant factors in the development of the disease due to their impact on urinary oxalate excretion. There are a number of strategies that can be employed to reduce oxalate excretion. The consumption of oxalate-rich foods should be avoided and calcium intake adjusted to 1000–1200 mg/day. To encourage compliance it should be emphasized to patients that they be vigilant with this diet as a deviation in any meal or snack could potentially result in significant stone growth. The evidence underlying these two modifications is outlined and other strategies to reduce urinary oxalate excretion are reviewed.

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Pyridoxine and Dietary Counseling for the Management of Idiopathic Hyperoxaluria in Stone-forming Patients

Cited by 47 publications

References 28 publications

The efficacy of antioxidant therapy against oxidative stress and androgen rise in ethylene glycol induced nephrolithiasis in Wistar rats

The efficacy of antioxidant therapy against oxidative stress and androgen rise in ethylene glycol induced nephrolithiasis in Wistar rats

Medical management of renal stones

Lowering urinary oxalate excretion to decrease calcium oxalate stone disease

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