orlistat and Hyperoxaluria

The purpose of this study was to examine the possible effects of a gastrointestinal lipase inhibitor "Orlistat (Xenical)" on the intestinal absorption of oxalate and thereby on the urinary levels of oxalate excretion in overweight patients.. Long-term follow-up data of 95 cases (57 men, 38 women; M/W=1.5) were documented. Patients were randomly assigned into two groups. While the patients in group I (n=55) were treated with orlistat (Xenical) for 6 months, patients in group II (n=40) received no specific medication. Calcium, oxalate, and citrate levels were determined in a 24-h urine collection from each patient. To evaluate the significance in the groups as well as the differences between the two groups, ANOVA test was performed and the results were given as mean +/- s.d.. Comparative evaluation of urinary oxalate levels during 3-month follow-up clearly showed that urinary oxalate excretion significantly increased in 34/55 patients (61.8%) in the first group (P<0.05). Of these 34 patients, 30 (88.2%) continued to have increased urinary oxalate excretion during 6-month follow-up (P=0.001). However, our data did not show any significant effect of this medication on urinary citrate and calcium levels during 3- and 6-month follow-up evaluation (P=0.05).. Our results suggest that increased intestinal absorption of dietary oxalate due to this type of medication in obese patients could make a substantial contribution to urinary oxalate excretion and may increase the risk of stone formation.

Topics: Adult; Anti-Obesity Agents; Calcium; Citric Acid; Enzyme Inhibitors; Female; Humans; Hyperoxaluria; Intestinal Absorption; Intestines; Lactones; Lipase; Male; Obesity; Orlistat; Oxalic Acid; Risk Assessment; Treatment Outcome; Up-Regulation; Urinary Calculi

We reported a case of oxalate crystal-related acute kidney injury caused by orlistat. The patient was admitted for nephrotic syndrome and acute kidney injury. The pathomorphological assessment of renal biopsy showed intratubular oxalate crystals. The patient reported that she had taken orlistat regularly to loss weight for more than a year. This patient had a habit of drinking vegetable soup and strong herbal tea daily. Orlistat, an intestinal lipase inhibitor, may cause secondary hyperoxaluria, that is, intestinal hyperoxaluria. Dietary habits could be a common precipitating factor for orlistat-relevant hyperoxaluria. It was comprehensively considered to be oxalate crystal-related acute renal injury, and the patient's renal function recovered gradually after drug withdrawal. Clinicians should pay attention to screening drug-related acute kidney injury including orlistat when observing patients with unexplained acute kidney injury, and renal biopsy should be performed if necessary. It is also important to warn people who take the orlistat for weight loss about the side effects of this drug so as to adjust the eating habits.. 报告1例奥利司他致草酸盐结晶相关急性肾损伤病例，该患者因肾病综合征、急性肾损伤入院，肾活检病理检查发现肾小管内草酸盐结晶。患者自诉因减肥而规律服用奥利司他1年余，平日喜饮蔬菜汤和浓凉茶，奥利司他作为肠道脂肪酶抑制剂可能导致继发性高草酸尿症，即肠源性高草酸尿症；饮食习惯是奥利司他致高草酸尿症的共同促发因素。本例患者停药后肾功能有所恢复。临床医生在处理不明原因急性肾损伤患者时应注意排查包括奥利司他在内的药物相关急性肾损伤，必要时可行肾活检。此外，服用该药的减肥人群应注意药物的不良反应，及时调整饮食习惯。.

Topics: Acute Kidney Injury; Female; Humans; Hyperoxaluria; Orlistat; Oxalates; Vegetables

Topics: Anti-Obesity Agents; Calcium Oxalate; Crystallization; Diagnosis, Differential; Female; Glomerular Filtration Rate; Humans; Hyperoxaluria; Hyperoxaluria, Primary; Kidney; Middle Aged; Orlistat; Renal Insufficiency; Renal Insufficiency, Chronic

Two patients developed kidney failure due to oxalate deposition in the kidney while taking orlistat. Cessation of orlistat was followed by partial recovery of kidney function. The mechanism by which orlistat causes hyperoxaluria and the management of orlistat-induced oxalate nephropathy is reviewed. We suggest that all patients taking orlistat are at risk of this condition, which may develop insidiously and is easily overlooked. Monitoring of kidney function of patients taking orlistat is warranted.

Topics: Aged; Anti-Obesity Agents; Calcium Oxalate; Female; Humans; Hyperoxaluria; Kidney Tubular Necrosis, Acute; Lactones; Male; Microscopy; Obesity; Orlistat; Renal Insufficiency, Chronic

This report describes a case of kidney failure secondary to orlistat, a lipase inhibitor commonly used in the treatment of obesity.. An 80-year-old man with type 2 diabetes who was being treated with orlistat developed rapidly progressive kidney failure. Low-grade albuminuria argued against diabetic nephropathy. Renal biopsy showed tubulointerstitial nephritis associated with numerous calcium oxalate crystals. Enteric hyperoxaluria was attributed to the orlistat treatment. The latter was stopped and the patient received calcium supplements. Six months after orlistat withdrawal, oxaluria was normalized and kidney function stabilized.. Oxalate nephropathy may result from hyperoxaluria secondary to orlistat treatment. This suggests that kidney function and oxaluria be closely monitored in patients taking orlistat.

Topics: Aged, 80 and over; Anti-Obesity Agents; Diabetes Mellitus, Type 2; Humans; Hyperoxaluria; Kidney Diseases; Lactones; Male; Orlistat

Topics: Anti-Obesity Agents; Biopsy; Diet; Female; Humans; Hyperoxaluria; Intestinal Mucosa; Intestines; Kidney; Kidney Diseases; Lactones; Middle Aged; Orlistat; Oxalic Acid; Rheum; Spinacia oleracea

Topics: Acute Disease; Anti-Obesity Agents; Biopsy; Calcium Oxalate; Enzyme Inhibitors; Humans; Hyperoxaluria; Hyperoxaluria, Primary; Kidney; Kidney Cortex Necrosis; Lactones; Lipase; Orlistat; Retrospective Studies