Calcium oxalate supersaturation increases early after Roux-en-Y gastric bypass

Agrawal, Varun; Liu, Xiao J.; Campfield, Thomas; Romanelli, John; Silva, J. Enrique; Braden, Gregory

doi:10.1016/j.soard.2013.03.014

Cited by 33 publications

(26 citation statements)

References 26 publications

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“…We separately analyzed data in 2 types of studies. First, we compared baseline urine chemistries before and after bariatric surgery, including 24-hour urine brushite SS (4 studies [16][17][18][19]), calcium (7 studies [16][17][18][19][20][21][22]), citrate (7 studies [16][17][18][19][20][21][22]), calcium oxalate SS (6 studies [16][17][18][19][20][21]), uric acid SS (5 studies [16][17][18][19]21]), oxalate (7 studies [16][17][18][19][20][21][22]), urine pH (6 studies [16,[18][19][20][21][22]), phosphorus (5 studies [16][17][18][19][20]), and volume (6 studies [16][17]<...>…”

Section: Meta-analysis Resultsmentioning

confidence: 99%

Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis

Upala

Jaruvongvanich

Sanguankeo

2016

Surgery for Obesity and Related Diseases

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Section: Meta-analysis Resultsmentioning

confidence: 99%

Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis

Upala

Jaruvongvanich

Sanguankeo

2016

Surgery for Obesity and Related Diseases

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“…This study examined stool and urine for respective fecal fat content and [20] Free drinking of water with powdered 3% glycolic acid Hyperoxaluria Hypocitraturia CaOx crystal deposits Ethylene Glycol (EG) [16,21e29] 0 This study also found that all RYGB rats had a 250% increase in water consumption and a 2-fold increase in urine volume excretion, regardless of dietary oxalate or fat content. While postulated to be due to altered thirst mechanisms [46], it highlights a major difference compared to results from previous human studies that have shown significant decreases in urine volume post-RYGB [44,47,48]. Future studies are needed to further elucidate the impact of RYGB and urinary volume production.…”

Section: Gastric Bypass Surgerymentioning

confidence: 81%

Animal models of urinary stone disease

Tzou

Taguchi

Chi

et al. 2016

International Journal of Surgery

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h i g h l i g h t sMultiple methods induce animal hyperoxaluria and calcium oxalate crystal formation. Knockout mice models have been shown to produce hypercalciuria and cystinuria. Drosophila melanogaster represents a powerful genetic model for stone disease. a r t i c l e i n f o a b s t r a c tThe etiology of stone disease remains unknown despite the major technological advances in the treatment of urinary calculi. Clinically, urologists have relied on 24-h urine collections for the last 30e40 years to help direct medical therapy in hopes of reducing stone recurrence; yet little progress has been made in preventing stone disease. As such, there is an urgent need to develop reliable animal models to study the pathogenesis of stone formation and to assess novel interventions. A variety of vertebrate and invertebrate models have been used to help understand stone pathogenesis. Genetic knockout and exogenous induction models are described. Surrogates for an endpoint of stone formation have been urinary crystals on histologic examination and/or urinalyses. Other models are able to actually develop true stones. It is through these animal models that real breakthroughs in the management of urinary stone disease will become a reality.

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“…A summary of mean 24-h urine data from retrospective RYGB, SG, or gastric banding surgeries are stratified by stone history in Table 1. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Prospectively collected 24-h urine chemistry profiles from primarily nonstone formers before and after either RYGB (n = 275) or BPD (n = 2) procedure are summarized in Table 1. [14][15][16][17][18][19] In the six prospective studies, 24-h urine chemistry profiles collected from 277 patients in a mean of 11 months after RYGB or BPD, revealed a 36.4% increase (28 to 44 mg/day) in urine oxalate levels after their bariatric surgery.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, urinary citrate levels continuously decreased reaching a 6-month low of 305 mg/day compared with 540 mg/day at baseline. 19 Recently, Lieske et al analyzed 24-h urinary chemistry profiles in 55 bariatric surgical patients with stone formation and 248 bariatric surgical patients without stones after either standard RYGB, BDP, very long limb RYGB, and SG; as well as 20 obese stone former controls without previous history of bariatric surgery. 30 A significant difference ( p < 0.001) was seen in urine oxalate excretion (0.70 mmol/ day = 63.0 mg/day) in 42 of the 55 stone formers at >8 months after their respective bariatric surgeries compared with 112 nonstone formers at >8 months (42.3 mg/day).…”

Section: Resultsmentioning

confidence: 99%

Kidney Stones After Bariatric Surgery: Risk Assessment and Mitigation

Espino-Grosso

Canales

2017

Bariatric Surgical Practice and Patient Care

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Obesity is rampant across the spectrum of age, gender, and race in the Unites States. Paralleling this epidemic, kidney stone prevalence is also rising, affecting nearly 1 in 11 individuals. Bariatric surgical procedures, such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), are the most effective weight loss options for morbidly obese or severely obese individuals with comorbidities. A number of studies have linked kidney stone development to bariatric surgical history, particularly RYGB, which portends up to a threefold increase in calcium oxalate stone risk compared with age-matched, obese controls. Stone development after malabsorptive (RYGB) and restrictive (SG) bariatric procedures are driven primarily by alterations in 24-h urine profiles, such as increased urinary oxalate, decreased urine volume, and reduced urinary citrate levels-all of which have been linked to increased kidney stone risk. What clinical recommendations, if any, can be given to reduce kidney stone risk in bariatric kidney stone patients? This review provides not only updated stone incidence and 24-h urine data in this population, but also reassurance-the metabolic alterations that result from bariatric surgery can be successfully mitigated by increased provider awareness, patient education, and a combination of dietary and pharmacological adjustments.

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Calcium oxalate supersaturation increases early after Roux-en-Y gastric bypass

Cited by 33 publications

References 26 publications

Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis

Risk of nephrolithiasis, hyperoxaluria, and calcium oxalate supersaturation increased after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis

Animal models of urinary stone disease

Kidney Stones After Bariatric Surgery: Risk Assessment and Mitigation

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