oxalates and Anemia

The hypoxia-inducible factor (HIF) family of transcription factors is responsible for coordinating the cellular response to low oxygen levels in animals. By regulating the expression of a large array of target genes during hypoxia, these proteins also direct adaptive changes in the hematopoietic, cardiovascular, and respiratory systems. They also play roles in pathological processes, including tumorogenesis. In recent years, several oxygenases have been identified as key molecular oxygen sensors within the HIF system. The HIF hydroxylases regulate the stability and transcriptional activity of the HIF-alpha subunit by catalyzing hydroxylation of specific proline and asparaginyl residues, respectively. They require oxygen and 2-oxoglutarate (2OG) as co-substrates, and depend upon non-heme ferrous iron (Fe(II)) as a cofactor. This article summarizes current understanding of the biochemistry of the HIF hydroxylases, identifies targets for their pharmacological manipulation, and discusses their potential in the therapeutic manipulation of the HIF system.

Topics: Anemia; Animals; Brain Ischemia; Enzyme Inhibitors; Gastrointestinal Diseases; Humans; Hypertension, Pulmonary; Hypoxia-Inducible Factor 1; Iron; Iron Chelating Agents; Ketoglutaric Acids; Kidney Diseases; Mice; Myocardial Ischemia; N-substituted Glycines; Neoplasms; Oxalates; Oxygen; Procollagen-Proline Dioxygenase; Rats

We present a rare case of anaemia secondary to bone marrow infiltration by oxalate crystals and renal failure in a patient diagnosed with primary hyperoxaluria. In our case, the anaemia was recovered after the double liver and kidney transplantation, the latter was performed on two occasions after the failure of the first graft.

Topics: Anemia; Bone Marrow; Humans; Hyperoxaluria; Kidney Transplantation; Liver Transplantation; Male; Middle Aged; Oxalates; Renal Insufficiency

Anemia is an important cause of morbidity in patients suffering from chronic renal failure, and erythropoietin is a milestone of anemia treatment. Various factors may cause erythropoietin resistance. Herein, we describe the case of 32-year-old man who presented with anemia and weakness. He developed progressive renal failure secondary to recurrent kidney stones. One year before admission, he developed anemia for which he had been treated with erythropoietin. However, the anemia persisted. Examination of bone marrow biopsy specimen showed that the marrow was extensively replaced with oxalate crystals and fibrous connective tissue with severe decrease of hematopoietic cells. To the best of our knowledge, our patient represents the first case in the literature describing the association between the oxalate deposition and EPO resistance.

Topics: Adult; Anemia; Biopsy, Needle; Bone Marrow Diseases; Chronic Disease; Drug Resistance; Erythropoietin; Follow-Up Studies; Humans; Hyperoxaluria; Immunohistochemistry; Kidney Calculi; Kidney Failure, Chronic; Male; Oxalates; Renal Dialysis; Risk Assessment; Severity of Illness Index; Treatment Failure

Topics: Adolescent; Anemia; Child; Child, Preschool; Europe; Female; Follow-Up Studies; Graft Survival; Growth; Hospitals, Pediatric; Humans; Infant; Kidney Diseases; Kidney Transplantation; Male; Oxalates; Puberty; Renal Dialysis; Transplantation, Homologous

A review of the problems associated with extensive jejunoileal bypass for morbid obesity in a series of 175 carefully selected patients is presented. Five postoperative deaths occurred (3%). Nonfatal complications occurred in 21%, with wound infections (14 patients) being the most common. Good results marked by weight reduction to the range of ideal weight without significant electrolyte or metabolic aberrations was observed in 82% of the patients receiving the current dimensional modificatiom of end-to-end jejunoileal bypass (30 cm to 20cm). An additional 13% had fair results and only 5% had poor results. There were six deaths during follow-up: liver failure in four patients (secondary to alcohol abuse in two), myocardial infarction in one, and one from unknown causes. Bypass reversal was necessary for refractory liver failure in three patients (two from alcohol abuse), and for persistent diarrhea with secondary electrolyte depletion in two patients. One of these patients was complicated by severe emotional instability. This experience suggests that the majority of carefully selected patients will have a good response to jejunoileal bypass.

Topics: Adolescent; Adult; Anemia; Avitaminosis; Body Weight; Cholelithiasis; Diarrhea; Electrolytes; Fatty Liver; Female; Follow-Up Studies; Gout; Humans; Hypoproteinemia; Ileum; Jejunum; Kidney Calculi; Liver Diseases; Male; Middle Aged; Obesity; Oxalates; Postoperative Complications

Topics: Alkaline Phosphatase; Anemia; Animal Nutritional Physiological Phenomena; Animals; Body Weight; Chlorides; Erythrocyte Count; Female; Hematocrit; Hemoglobins; Iron; Male; Oleic Acids; Organ Size; Oxalates; Oxides; Phosphates; Rats; Sex Factors; Sulfates; Sulfides; Tartrates; Tin; Transaminases

Topics: Anemia; Anemia, Hypochromic; Anuria; Hematologic Diseases; Humans; Hyperoxaluria; Kidney Calculi; Oxalates; Toxicology

Topics: Anemia; Anemia, Pernicious; Blood; Butyrates; Enzyme Inhibitors; Erythrocytes; Gastric Mucosa; Isoenzymes; Kidney; L-Lactate Dehydrogenase; Liver; Muscles; Myocardium; Oxalates; Pyruvates; Research; Spectrophotometry