oxalates and Chronic-Disease

Calcium stones are common and recurrent in nature, yet few therapeutic tools are available for secondary prevention. Personalized approaches for stone prevention have been informed by 24-hour urine testing to guide dietary and medical interventions. However, current evidence is conflicting about whether an approach guided by 24-hour urine testing is more effective than a generic one. The available medications for stone prevention, namely thiazide diuretics, alkali, and allopurinol, are not always prescribed consistently, dosed correctly, or tolerated well by patients. New treatments on the horizon hold the promise of preventing calcium oxalate stones by degrading oxalate in the gut, reprogramming the gut microbiome to reduce oxalate absorption, or knocking down expression of enzymes involved in hepatic oxalate production. New treatments are also needed to target Randall's plaque, the root cause of calcium stone formation.

Topics: Alkalies; Allopurinol; Body Fluids; Calcium; Chronic Disease; Humans; Oxalates

Topics: Africa; Asia; Calcium; Chemical Precipitation; Child; Child, Preschool; Chronic Disease; Depression, Chemical; Ethnicity; Europe; Female; Humans; Infant; Kidney Calculi; Lymphatic Diseases; Magnesium; Male; Methylene Blue; Mucoproteins; Oxalates; Phosphates; Protein Binding; Proteinuria; Recurrence; Sex Factors; Sodium; Solubility; United States; Urinary Bladder Calculi

Topics: Acute Disease; Animals; Antineoplastic Agents; Calcium Channels; Chronic Disease; Humans; Mice; Nerve Tissue Proteins; Organoplatinum Compounds; Oxalates; Oxaliplatin; Peripheral Nervous System Diseases; Transient Receptor Potential Channels; TRPA1 Cation Channel

Topics: Acute Kidney Injury; Chronic Disease; Comorbidity; Gastric Bypass; Humans; Incidence; Kidney; Kidney Diseases; Obesity, Morbid; Oxalates; Risk Factors; Treatment Outcome

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

The aim of this study was to evaluate possible changes in renal hemodynamic and urodynamic parameters in rats with chronic hyperoxaluria and after acute oxalate challenge. We also evaluated the possible association between free radical (FR) production, hyperoxaluria, and calcium oxalate (CaOx) calculi formation.. Chronic hyperoxaluria was induced by adding 0.75% ethylene glycol (EG) to the drinking water of male Wistar rats. After 7, 21, and 42 days of treatment, urinary biochemistry, oxalate levels, and lipid peroxides were measured. Kidney calculi were examined by polarizing microscopy. In the second part of the experiments, 1, 10, 20, and 30 mg kg(-1) hr(-1) oxalate was infused, by means of an intrarenal arterial catheter (IRA), into normal rats sequentially. Superoxide dismutase (SOD) infusion by means of IRA, in addition to oxalate, was also performed to check its influence on the altered renal function after oxalate infusion. In both the acute and chronic groups, renal blood flow (RBF), cortical microvascular blood flow (CMVBF), glomerular filtration rate (GFR), urine flow (UV), and urinary sodium excretion (U(Na)V) were measured, and chemiluminescence (CL) was examined in the renal venous blood.. Levels of urinary lipid peroxides and enzymuria had increased since day 7, and increased the size of numbers of CaOx crystals in the kidney were noted beginning on day 21, but elevated CL was detectable only on day 7 after 0.75% EG treatment. Decreased UV and U(Na)V were noted in the 42-day EG group, although the 24-hr creatinine clearance values were normal in all experimental groups. On the other hand, RBF, GFR, and CMVBF were attenuated with elevated FR when the oxalate concentration was higher than 10 mg kg(-1) hr(-1) in the acute oxalate infusion group. With SOD pretreatment, the decreased RBF, GFR, and CMVBF could be reversed at 10 mg kg(-1) hr(-1) of oxalate, and be partially reversed at 20. FR also could be reduced significantly at 10 and 20 mg kg(-1) hr(-1) of oxalate.. Decreased urine flow and sodium excretion were the main renal functions affected by chronic hyperoxaluria. However, that only the 42-day EG group had a decreased tubular function cannot be fully explained by the persistent tubular enzymuria and increased lipid peroxides that began on day 7 after EG treatment. With acute oxalate infusion, the major insult to renal function was renal hemodynamics. Pretreated SOD could reverse the attenuated hemodynamics and reduce the elevated FR partly, which suggested that FR is responsible for oxalate toxicity.

Topics: Acute Disease; Animals; Chronic Disease; Ethylene Glycol; Free Radicals; Glomerular Filtration Rate; Hyperoxaluria; Injections, Intra-Arterial; Luminescent Measurements; Male; Oxalates; Rats; Rats, Wistar; Renal Artery; Renal Circulation; Superoxide Dismutase; Urodynamics

A 37-year-old patient underwent two successive renal transplantations 7 months apart. He remained dialysis dependent. Early biopsy of both grafts revealed widespread calcium oxalate deposition suggestive of acute oxalate nephropathy. Several causes of oxalate nephropathy, including primary oxalosis and an increased intake of oxalic acid precursors, were excluded. Two years later, the identification of steatorrhea with radiologic signs of chronic pancreatitis led to the hypothesis of enteric hyperoxaluria. Surprisingly, 11 months after the second transplantation, graft function improved progressively allowing interruption of dialysis. Three years later, renal function is stable. The causes and prevention of acute oxalate-induced graft failure are highlighted. Subclinical evidence of enteric hyperoxaluria should be looked for and appropriate therapy instituted as early as possible. The possibility of a late recovery of renal function warrants attentive patience from attending physicians.

Topics: Acute Kidney Injury; Adult; Celiac Disease; Chronic Disease; Humans; Hyperoxaluria; Kidney; Kidney Transplantation; Klinefelter Syndrome; Male; Oxalates; Pancreatitis; Reoperation; Treatment Failure; Treatment Outcome

Topics: Acute Kidney Injury; Aged; Biopsy; Chronic Disease; Enzyme Therapy; Humans; Kidney Tubules, Distal; Male; Oxalates; Pancreatitis; Spectroscopy, Fourier Transform Infrared

Topics: Adult; Bone Marrow; Chronic Disease; Crystallization; Female; Humans; Kidney Diseases; Oxalates

Enteric hyperoxaluria, a complication of jejuno-ileal bypass, is associated with renal failure owing to oxalate nephrosis or tubulo-interstitial nephritis. A 54 year old woman developed renal failure 17 months after jejuno-ileal bypass for morbid obesity. Renal biopsy showed widespread acute on chronic damage to the tubulo-interstitial compartment with extensive deposition of oxalate crystals. The extent of oxalate deposition was only evident on polarisation of the biopsy.

Topics: Acute Kidney Injury; Biopsy; Chronic Disease; Female; Humans; Hyperoxaluria; Jejunoileal Bypass; Microscopy, Polarization; Middle Aged; Nephrosis; Oxalates

The paper presents the results of clinical and laboratory examination made in 3 groups of children: populational, hospital and control (a total of 176 patients). The children were diagnosed to have variants of dysmetabolic nephropathy (DN) which had become a problem not only for urolithiasis-endemic regions, but also for the Middle Russia. The study involving characterization of cytomembranes, renal tissue biopsy allowed conclusion on nonspecific DN symptoms. Obligatory symptoms were those of OCC, microhematuria and/or mild proteinuria, changes in cytomembranes, weak tubular function, tubulo-interstitial changes. DN genesis is thought multifactorial, involving genetic predisposition, biochemical defects, ecological hazards.

Topics: Adolescent; Biopsy; Child; Child, Preschool; Chronic Disease; Crystallization; Humans; Incidence; Infant; Kidney; Kidney Calculi; Kidney Diseases; Lipids; Moscow; Oxalates; Terminology as Topic

A study was made of 819 patients attending a metabolic stone clinic. A firm diagnosis was made in 708 (86%) and in 132 of these (19%) the diagnosis was thought to be chronic dehydration. The records were available for study for 87 males and 11 females in the chronic dehydration group. The mean age at presentation was 43 years. The causes of chronic dehydration were hot climate (62%), with hot occupation and low water intake almost equal in second place. In patients with a single cause of chronic dehydration, 57% also had a dietary risk factor for urolithiasis and this was most commonly high oxalate intake. Following dietary advice, the mean urinary volume increased from 1720 to 2475 ml/24 h. This was accompanied by a rise in mean urinary calcium from 6.02 to 6.96 mmol/24 h, presumably due to the calcium in the additional water drunk. Urinary oxalate did not change significantly. The mean follow-up time was 4.85 years and the stone recurrence rate was low. It was concluded that chronic dehydration is a common cause of urolithiasis; this can be treated satisfactorily by increasing water intake plus dietary advice in certain cases.

Topics: Adult; Calcium; Chronic Disease; Dehydration; Diet; Drinking; Female; Follow-Up Studies; Hot Temperature; Humans; Male; Occupations; Osmolar Concentration; Oxalates; Risk Factors; Sports; Urinary Calculi

The increased oxalic acid absorption is a well documented finding in gastroenterological diseases. The malabsorption of bile acids and fat is important in the pathogenesis of the hyperoxaluria. The enteric absorption of 14C-labelled oxalic acid was measured in 49 patients with different diseases. The dihydroxy-trihydroxy-ratio of bile acids is significantly decreased in patients with hyperoxaluria over 20% of the ingested dosage. We didn't find any correlation between the excretion of oxalic acid and the intraduodenal pancreatic lipase activity.

Topics: Adult; Bile Acids and Salts; Chronic Disease; Crohn Disease; Female; Humans; Hyperoxaluria; Intestinal Absorption; Jejunoileal Bypass; Lipase; Male; Middle Aged; Oxalates; Oxalic Acid; Pancreatitis; Postoperative Complications

The enteric absorption of oxalic acid with 14C-labelled oxalic acid was determined in patients with small bowel resection, jejunoileal bypass, Crohn's disease and chronic pancreatitis in comparison to the control group. Extreme hyperoxaluria were found in small bowel resections above 100 cm, after bypass operations and in ileocolitis Crohn with signs of clinical activity. Small bowel resections and relapses of Crohn's disease increase the absorption of oxalic acid. The significance of 14C-oxalic acid absorption test is the recognition of enteric hyperoxaluria.

Topics: Chronic Disease; Crohn Disease; Humans; Hyperoxaluria; Intestinal Absorption; Intestine, Small; Jejunoileal Bypass; Oxalates; Oxalic Acid; Pancreatitis; Postoperative Complications; Whipple Disease

Principally the formation of urinary calculi in children is not very different from that of grown-ups. For children some factors, however, are of special relevance namely recurrent urinary tract infections and malformations in the area of the urinary tract. In western countries nowadays the incidence rate of urinary stones in children is 3-5% of all patients suffering from this disease, in the underdeveloped countries we have rates of about 30%. A clear sex preference in children wasn't found, the age distribution shows that for half of the children suffering from calculi, diagnosis has been made until they've reached school age. Stone localisation is shifting towards the upper urinary tract, in the past we had mainly urinary bladder stones. Concrements containing oxalate are being found more often today. For children we have a high proportion of mixed concrements. The rate of recurrence for children is 15-25%. Diagnostically we have to search out especially for malformations respectively obstructions of the urine flow, disturbances in metabolism in consideration of metaphylaxis possibilities, however, must not be taken out of account either. Promotory and inhibitory factors of stone formation are presented and their significance is explained by means of selected cases of our own patients. Modern techniques of operative resp. instrumental removal of urinary calculi are presented, especially the relevance of modern strategies as e.g. the extracorporal shock wave lithotripsy, percutaneous litholapaxy and ureterorenoscopy are discussed. Adequate metaphylaxis (general, dietetic, medicamentous) can lower the rate of recurrence of stone formation. This is only possible, however, on condition of a consequent diagnosis to find possible causes of stone formation to be able to choose the right measures of metaphylaxis.

Topics: Calcium; Child; Chronic Disease; Humans; Kidney; Kidney Calculi; Oxalates; Oxalic Acid; Pressure; Urea; Ureteral Calculi; Uric Acid; Urinary Tract Infections; Urodynamics

A 38-year-old woman suffered rapid onset of renal failure between 11 and 15 months after undergoing a jejunoileal bypass for morbid obesity. Microscopic examination of renal biopsy specimens revealed oxalosis and severe tubulointerstitial nephritis. Immunofluorescence microscopy disclosed linear staining of tubular basement membranes with antisera to IgG and C3, which suggests antitubular basement membrane disease, a side effect not previously recognized with jejunoileal bypass. Possible mechanisms leading to the formation of these antibodies include (1) oxalate damage to renal tubules with release of tubular basement membrane antigens, and (2) bacterial overgrowth in the bypass segment, with mucosal damage and release of intestinal mucosal antigens that share antigenetic determinants with renal proximal tubules. Anti-tubular basement membrane disease may be an additional mechanism that produces or enhances renal damage in patients with jejunoileal bypass.

Topics: Adult; Antibodies; Basement Membrane; Chronic Disease; Complement C3; Female; Humans; Ileum; Immunoglobulin G; Jejunum; Kidney Tubules; Microscopy; Microscopy, Electron; Nephritis, Interstitial; Obesity; Oxalates; Postoperative Complications

Oxalate-urolithiasis and hyperoxalaria have been reported to be a frequent complication in patients with small bowel disease, especially in patients with ileal resection due to Crohn's disease. Hyperabsorption of oxalate seems to be the main patholgenetic factor for "enteric" hyperoxalaria. Intestinal absorption and urinary excretion of oxalate was measured in patients with various gastrointestinal diseases after oral or rectal administration of 14C-oxalate. Kinetic data suggest that 14C-oxalate is absorbed in the small, the large bowel and the rectum as well. Oxalate absorption was decreased in patients with a colectomy and in active ulcerative colitis, but increased in patients with ileal resection, chronic liver disease, and steatorrhea due to chronic pancratitis or sprue. There existed a positive correlation between 14C-oxalate absorption and the amount of fecal fat excretion. The data suggest that hyperoxaluria and hyperabsorption of oxalate are not a specific finding in patients with bile acid malabsorption, but may occur too, in steatorrhea without alteration of bile acid metabolism.

Topics: Celiac Disease; Chronic Disease; Colitis, Ulcerative; Colon; Gastrointestinal Diseases; Humans; Ileum; Intestinal Absorption; Liver Diseases; Oxalates; Pancreatitis; Postoperative Complications; Rectum; Urinary Calculi

100 g of spinach a day was added to the hospital diet of fifty-four patients with suspected malabsorption. Hyperoxaluria was found in thirty-eight patients; all of them had steatorrhoea. No patient with steatorrhoea had a urinary oxalate excretion of less than 40 mg a day. Ten other patients had hyperoxaluria, but the faecal fat determinations were regarded as unreliable in almost all and malabsorption could not be confirmed. It is suggested that in clinical practice determination of urinary oxalate after an oral load of oxalate could replace faecal fat determination in most patients with suspected malabsorption.

Topics: Adolescent; Adult; Aged; Carcinoma; Celiac Disease; Chronic Disease; Crohn Disease; Diet; Feces; Humans; Hypoparathyroidism; Lipids; Liver Cirrhosis; Middle Aged; Oxalates; Pancreatitis; Peptic Ulcer; Thyroid Neoplasms; Vegetables

A perfusion technique has been used to study the effect of sodium chenodeoxycholate (5 mmol 1-1) on absorption of oxalate (2 mmol 1-1) from the surgically excluded colon in two patients with chronic liver disease. Colonic absorption of oxalate increased at least fivefold when sodium chenodeoxycholate was incorporated in the perfusion solutions. This observation may explain enteric hyperoxaluria after ileal resection and in some other gastrointestinal disorders.

Topics: Adult; Aged; Chenodeoxycholic Acid; Chronic Disease; Colon; Humans; Intestinal Absorption; Liver Diseases; Oxalates; Perfusion; Time Factors; Water

A 32-year-old woman, patient of chronic glomerulonephritis whose total clinical course was 3 years. During this period intensive peritoneal and hemodialyses were performed. Autopsy revealed deposition of calcium oxalate in the kidneys and the other main organs as well as chronic glomerulonephritis. And it was thought that the patient was accompanied by secondary hyperoxaluria.

Topics: Adult; Chronic Disease; Female; Glomerulonephritis; Histocytochemistry; Humans; Kidney; Myocardium; Oxalates; Parathyroid Glands; Peritoneal Dialysis; Renal Dialysis

Topics: Acidosis, Renal Tubular; Acute Disease; Analgesics; Calcium; Chronic Disease; Cystinuria; Female; Humans; Hyperparathyroidism; Infrared Rays; Kidney Calculi; Male; Oxalates; Radiography; Spectrum Analysis; Ureteral Calculi; Urinary Calculi; Urinary Tract Infections; X-Ray Diffraction

Topics: Adult; Amino Acid Metabolism, Inborn Errors; Basement Membrane; Biopsy; Chronic Disease; Crystallization; Female; Glycine; Humans; Inclusion Bodies; Kidney Cortex; Kidney Diseases; Kidney Glomerulus; Kidney Medulla; Kidney Tubules; Male; Microscopy, Electron; Middle Aged; Oxalates

Topics: Chromatography, Paper; Chronic Disease; Dihydroxyphenylalanine; Dopamine; Erythrocytes; Hemolysis; Heparin; Humans; Male; Melanins; Norepinephrine; Oxalates; Schizophrenia; Spectrophotometry; Ultraviolet Rays

Recent epidemiological studies have shown that death-rates from certain chronic diseases are higher in areas with soft than in areas with hard drinking-water. In the striking negative correlation found in the county boroughs of England and Wales between cardiovascular mortality and water hardness the important underlying factor is apparently the water calcium. Interest is therefore focused on the dietary significance of calcium present in drinking-water. In relation to that interest, the present report gives a quantitative account of the composition of tea infusions prepared with waters containing different amounts of calcium. It is shown that a substantial part of water calcium is taken up by the tea leaf during the preparation of infusions. The analysis of the infusions covers a wide range of individual components, including trace metals and polyphenolic substances. It appears that the principal change caused in infusion composition by the presence of calcium in the water is a substantial reduction in the relatively high oxalate content. The question is raised whether there may be some connexion between the ;water factor' in cardiovascular disease and the absorption of oxalates from foods.

Topics: Caffeine; Calcium; Calcium, Dietary; Chronic Disease; England; Humans; Inositol; Metals; Mortality; Nitrogen; Oxalates; Pectins; Phenols; Phosphates; Tea; Wales; Water; Water Supply

Topics: Adrenochrome; Adult; Chromatography, Paper; Chronic Disease; Epinephrine; Erythrocytes; Fluorescence; Hemolysis; Heparin; Humans; Indoles; Male; Melanins; Middle Aged; Oxalates; Schizophrenia; Spectrum Analysis

Topics: Chronic Disease; Humans; Otitis Media; Oxalates; Temporal Bone