oxalates and Syndrome

This article reviews the mechanisms involved in the synthesis, absorption, excretion and transport of oxalic acid, and the factors controlling these processes in man. The clinical syndromes associated with hyperoxaluria and recurrent calcium oxalate stone disease are reviewed, including new studies that raise the possibility of a generalized oxalate transport abnormality in some patients with renal stone disease. The important role of oxalate in the determination of calcium oxalate solubility in patients with calcium oxalate stone disease is emphasized and future directions for research in the prevention of recurrent calcium oxalate stone disease are discussed.

Topics: Animals; Biological Transport; Calcium Oxalate; Humans; Hyperoxaluria; Intestinal Absorption; Kidney; Oxalates; Syndrome; Urinary Calculi

Topics: Adult; Animals; Calcium; Child; Diet; Humans; Kidney Calculi; Metabolism, Inborn Errors; Oxalates; Syndrome

This study was undertaken to determine the urinary oxalate excretion patterns in patients with vulvodynia compared with controls and to evaluate antioxalate therapy in women with vulvar pain syndrome (vulvodynia).. A total of 130 consecutive patients with vulvar pain syndrome and 23 volunteers without symptoms collected urine specimens for 24 hours; each voiding was saved in individual labeled containers and refrigerated. The specimens were analyzed individually for oxalate and calculated according to 24-hour concentration, volume, and peak oxalate by hour. A total of 59 patients were treated with low-oxalate diets and calcium citrate for 3 months and evaluated for objective relief of vulvar pain.. The 24-hour excretion of oxalate was almost identical in controls and vulvodynia patients. The total 24-hour excretion was directly proportional to the volume of urine excreted (p < 0.001). No significant differences were found in peak oxalate excretion (95% confidence intervals). The number of voidings was higher in the vulvodynia cohort (p < 0.02). The 59 women with elevated oxalate concentrations (> 1 mg/40 dl) were treated with an antioxalate regimen. Fourteen (24%) demonstrated an objective response, but only 6 (10%) could have pain-free sexual intercourse.. Urinary oxalates may be nonspecific irritants that aggravate vulvodynia; however, the role of oxalates as instigators is doubtful.

Topics: Circadian Rhythm; Cohort Studies; Female; Humans; Oxalates; Pain; Prospective Studies; Syndrome; Vulvar Diseases

To differentiate hyperoxaluria syndromes we measured plasma and urine glycolate by a novel high performance liquid chromatographic procedure. Mean glycolate level was 7.9 +/- 2.4 mumol./l. in plasma and 422 +/- 137 mumol./24 hours in urine from 19 control subjects. Renal clearance was about 50% the glomerular filtration rate irrespective of the underlying disease. There was close correlation between glycolate and oxalate in plasma. Plasma glycolate was normal in all but 8 patients who had primary hyperoxaluria 1. Plasma assay detected the disease more efficiently than urine assay. Pyridoxine decreased oxalate biosynthesis in 2 of the 4 patients treated with it and glycolate assay confirmed this behavior. Glycolate excretion was significantly high in 3 of 8 patients of primary hyperoxaluria 1 patients. Idiopathic stone formers had mild increases in glycolate excretion but this was not related with oxalate excretion. Glycolate levels were normal in 5 patients with enteric hyperoxaluria. We conclude that glycolate assay is essential for identifying patients with primary hyperoxaluria 1 and may represent a valuable tool for differentiating hyperoxaluria.

Topics: Adolescent; Adult; Child; Diagnosis, Differential; Female; Glycolates; Humans; Hyperoxaluria; Male; Middle Aged; Oxalates; Syndrome

We have studied the urinary excretion of oxalate and glycollate in patients with the Zellweger syndrome and hyperoxaluria type I and have measured the activity of alanine glyoxylate aminotransferase (a peroxisomal enzyme in man) in the patients. In agreement with earlier reports we found that alanine glyoxylate aminotransferase was strongly deficient in liver from a hyperoxaluria type I patient, thus explaining the increased urinary excretion of oxalate and glycollate in these patients. In livers from Zellweger patients, however, in which morphologically distinguishable peroxisomes are absent, the enzyme was not deficient, which is in accordance with our finding that the urinary excretion of oxalate and glycollate was normal in these patients.

Topics: Adolescent; Aging; Alanine Transaminase; Child; Child, Preschool; Glycolates; Humans; Hyperoxaluria; Infant; Liver; Male; Microbodies; Oxalates; Syndrome; Transaminases

Topics: alpha-Tocopherol; Animals; Humans; Kidney; Oxalates; Polysorbates; Rats; Syndrome; Tocopherols; Vitamin E

The results of sodium oxalate treatment undertaken in 25 patients with various forms of myotonias are presented. The beneficial effect of the drug is confirmed by the clinical, biochemical and electromyographic findings.

Topics: Adolescent; Adult; Calcium; Child; Creatine Kinase; Female; Humans; Male; Middle Aged; Myotonia Congenita; Oxalates; Oxalic Acid; Sarcoplasmic Reticulum; Syndrome

Topics: Adolescent; Adult; Age Factors; Aged; Allopurinol; Calcium; Child; Child, Preschool; Crystallization; Diet; Female; Humans; Infant; Infant, Newborn; Kidney Calculi; Male; Middle Aged; Oxalates; Purines; Syndrome; Uric Acid

A patient with chronic renal disease due to primary hyperoxaluria developed a rapidly progressing motor neuropathy with marked impairment of nerve conduction. Pathological studies demonstrated the presence of both axonal degeneration and segmental demyelination, together with the presence of oxalate crystals within axons. It is suggested that the development of peripheral neuropathy complicating hyperoxaluria is a consequence of the increased life-span mad possible by haemodialysis.

Topics: Adult; Carbohydrate Metabolism, Inborn Errors; Humans; Kidney Failure, Chronic; Male; Oxalates; Peripheral Nerves; Peripheral Nervous System Diseases; Syndrome

Calcium oxalate crystals were demonstrated in the retinal pigment epithelium (RPE) of a 66-year old white man with changes in the fundus oculi consistent with the flecked retina ayndrome. The patient had a history of rheumatoid arthritis, mild hypertension, and mild renal insufficiency presumed due to his hypertension. He underwent prolonged abdominal surgery under methoxyflurane anesthesia, following which he developed acute irreversible renal failure. Calcium oxalate crystals were demonstrated postoperatively in a kidney biopsy specimen. He subsequently was maintained on renal dialysis with decreasing renal function. Several weeks before his death fundus examination revealed a picture suggestive of a flecked retina syndrome. At autopsy, widespread oxalosis was found including crystals in the RPE and in some areas in the neural retina and cillary epithelium.

Topics: Acute Kidney Injury; Aged; Anesthesia; Autopsy; Biopsy; Calcium; Crystallization; Epithelium; Fundus Oculi; Humans; Kidney; Kidney Failure, Chronic; Male; Metabolic Diseases; Methoxyflurane; Oxalates; Retina; Retinal Diseases; Retinal Pigments; Syndrome

Of 125 patients with postsurgical acute tubular necrosis, 87 died, 34 regained clinical normal renal function, and 4 survivors (9.5%) were left with severe permanent renal failure, two of whom required chronic dialysis and transplantation. Preoperatively these 4 patients had normal renal function. The 4 patients were above age 60, two had undergone methoxyflurane anesthesia, and nephrotoxic antibiotics were used in all. The incidence of permanent renal failure is much higher than ever reported and may reflect the survival of patients who previously died because of less ideal dialysis. We believe that the cause of this permanent lesion is multifactorial, including age (over 60 years), nephrotoxic antibiotics (particularly cephalothin and gentamicin sulfate), and nephrotoxic anesthetic (methoxyflurane) agents. This combination of factors should be avoided whenever possible.

Topics: Acute Kidney Injury; Adolescent; Adult; Age Factors; Aged; Anesthetics; Anti-Bacterial Agents; Blood Urea Nitrogen; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Kidney Cortex; Kidney Failure, Chronic; Kidney Tubular Necrosis, Acute; Male; Methoxyflurane; Middle Aged; Oxalates; Postoperative Complications; Renal Dialysis; Sex Factors; Syndrome

Topics: Abdomen; Child; Child, Preschool; Diet; Diet Therapy; Female; Fever; Humans; Male; Migraine Disorders; Nausea; Oxalates; Pain Management; Photosensitivity Disorders; Syndrome; Vomiting

Topics: Bile Acids and Salts; Carbon Dioxide; Carbon Radioisotopes; Cholestyramine Resin; Female; Glycine; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Intestinal Diseases; Intestine, Small; Intestines; Middle Aged; Oxalates; Postoperative Complications; Syndrome; Urinary Calculi

Topics: Adult; Aged; Bacteria; Bacterial Infections; Bile Acids and Salts; Carbon Isotopes; Crohn Disease; Feces; Female; Glycine; Glycocholic Acid; Humans; Ileum; Intestinal Diseases; Male; Middle Aged; Oxalates; Syndrome

Topics: Animals; Calcium; Child; Conjunctivitis; Cornea; Fluoresceins; Humans; Inflammation; Keratoconjunctivitis; Male; Oxalates; Plant Extracts; Plants; Rabbits; Syndrome; Time Factors