Plasma oxalate concentration and oxalate distribution volume in patients with normal and decreased renal function

Prenen, J. A. C.; Mees, E. J. Dorhout; Boer, P. de

doi:10.1111/j.1365-2362.1985.tb00142.x

Cited by 21 publications

(13 citation statements)

References 19 publications

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“…In contrast to the positive correlation found by others, between the urinary clearances of creatinine and oxalate, and a constant ratio of 2 between the clearances of oxalate arid creatinine, in individuals with normal or impaired kidney function (15,28), we were unable to identify any such relationship. However, the experimental protocols applied by those authors were largely different from ours, apart from their use of the [ 34 C]oxalate isotope dilution method.…”

Section: Discussioncontrasting

confidence: 53%

“…The data are presented in the text in the form of tables and figures. Creatinine clearance and urinary oxalate excretion rate were regressed linearly and the possibility of calculation of plasma oxalate was tested, s proposed by others (15). Total variance between controls and the two groups of renal calcium urolithiasis patients was examined by the Kruskal-Wallis test, and the significance (p < 0.05) of differences was examined by the U-or t-test, depending on whether Gausnan distribution was absent or present (16).…”

Section: Calculations and Statisticsmentioning

confidence: 99%

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Oxalate Measurement in the Picomol Range by Ion Chromatography: Values in Fasting Plasma and Urine of Controls and Patients with Idiopathic Calcium Urolithiasis

Schwille¹,

Manoharan²,

Rümenapf³

et al. 1989

Clinical Chemistry and Laboratory Medicine

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Summary:Oxalate was measured by ion chromatography in the ultrafiltrate of heparinized plasma from peripheral venous blood, using a membrane with a cut-off molecular weight (M r ). The following criteria were established: sensitivity 0.7 μπιοί -1~J; intra-and inter-assay coefficients of Variation 4% and 12%, respectively; precision of duplicate determinations (expressed s Standard deviation) 0.08 μηιοί Ί" 1 ; overall recovery (oxalate added and diluted, respectively) 100.7%. These qualified the method for assessment of plasma oxalate in healthy human controls (males: n = 12) s well s patients with idiopathic renal calcium urolithiasis (males: n = 22; females: n = 16). Renal calcium urolithiasis patients were subclassified into those with normocalciuria and idiopathic hypercalciuria. In male and female controls the mean values (and r nge) of plasma oxalate were 1.98 (1.4 -2.5) and 1.78 (0.7 -2.9) μπιοί -l" 1 , respectively. In male controls Ultrafiltration (membrane cut off M r 10000) revealed that 11 -16% plasma oxalate was bound to constituents having an apparent A/ r above 10000, and that with use of membranes with smaller pore size, the ultrafilterability of oxalate decreases further. In renal calcium urolithiasis the following values were elicited (μηιοί-l" 1 )' male normocalciuria 1.78 (0.8-4.0), idiopathic hypercalciuria 1.58 (1.2-2.2); female normocalciuria 1.69 (0.8 -3.6), idiopathic hypercalciuria 1.21 (0.8 -2.1). The difference from controls is significant in idiopathic hypercalciuria (males and females). In contrast, in fasting urine of renal calcium urolithiasis the oxalate excretion rate (5-45 μηιοί per 120 min) and oxalate clearance (21-328 ml per min) resemble those in controls, whereas in renal calcium urolithiasis the fractional oxalate clearance (30-357% of creatinine clearance) tended to higher values (p < 0.01, in male idiopathic hypercalciuria versus controls).^It is suggested that 1) ion chromatography allows the reliable assessment of ultrafiltrable plasma oxalate in health and disease states, 2) in renal calcium urolithiasis this technique may help to ehicidate oxalate pathophysiology, especially the mode of renal handling of oxalate.

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Section: Discussioncontrasting

confidence: 53%

Section: Calculations and Statisticsmentioning

confidence: 99%

Oxalate Measurement in the Picomol Range by Ion Chromatography: Values in Fasting Plasma and Urine of Controls and Patients with Idiopathic Calcium Urolithiasis

Schwille¹,

Manoharan²,

Rümenapf³

et al. 1989

Clinical Chemistry and Laboratory Medicine

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“…As GFR declines, renal oxalate clearance is decreasing, which leads to increased plasma oxalate as depicted in Figure 1C [59, 119, 120, 121, 122, 123, 124, 125]. Mean plasma oxalate levels reported for different kinds of chronic renal disease are above normal limits and inversely correlate with GFR [123, 126].…”

Section: Oxalate and Ckdmentioning

confidence: 99%

Oxalate, inflammasome, and progression of kidney disease

Ermer

Eckardt²,

Aronson³

et al. 2016

Current Opinion in Nephrology and Hypertension

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Purpose of review Oxalate is an end product of metabolism excreted via the kidney. Excess urinary oxalate, whether from primary or enteric hyperoxaluria, can lead to oxalate deposition in the kidney. Oxalate crystals are associated with renal inflammation, fibrosis and progressive renal failure. It has long been known that as glomerular filtration rate (GFR) becomes reduced in chronic kidney disease (CKD), there is striking elevation of plasma oxalate. Taken together, these findings raise the possibility that elevation of plasma oxalate in CKD may promote renal inflammation and more rapid progression of CKD independent of primary etiology. Recent findings The inflammasome has recently been identified to play a critical role in oxalate-induced renal inflammation. Oxalate crystals have been shown to activate the nucleotide-binding domain, leucine-rich repeat inflammasome 3 (also known as NALP3, NLRP3 or cryopyrin), resulting in release of Interleukin-1β and macrophage infiltration. Deletion of inflammasome proteins in mice protects from oxalate-induced renal inflammation and progressive renal failure. Summary The findings reviewed in this article expand our understanding of the relevance of elevated plasma oxalate levels leading to inflammasome activation. We propose that inhibiting oxalate-induced inflammasome activation, or lowering plasma oxalate, may prevent or mitigate progressive renal damage in CKD, and warrants clinical trials.

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“… 1 , 2 With declining kidney function, renal oxalate clearance decreases and oxalate accumulates. 3 , 4 , 5 , 6 , 7 In patients with end-stage renal disease (ESRD), plasma oxalate (P Ox ) concentrations frequently exceed the oxalosis cutoff of 30 μmol/l. 8 , 9 , 10 Elevated P Ox can lead to oxalate deposition in various tissues and can cause organ damage.…”

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confidence: 99%

Impact of Regular or Extended Hemodialysis and Hemodialfiltration on Plasma Oxalate Concentrations in Patients With End-Stage Renal Disease

Ermer

Kopp

Asplin

et al. 2017

Kidney International Reports

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IntroductionCalcium oxalate supersaturation is regularly exceeded in the plasma of patients with end-stage renal disease (ESRD). Previous reports have indicated that hemodialfiltration (HDF) lowers elevated plasma oxalate (POx) concentrations more effectively compared with hemodialysis (HD). We reevaluate the therapeutic strategy for optimized POx reduction with advanced dialysis equipment and provide data on the effect of extended treatment time on dialytic oxalate kinetics.MethodsFourteen patients with ESRD who underwent HDF 3 times a week for 4 to 4.5 hours (regular HDF; n = 8) or 7 to 7.5 hours (extended HDF; n = 6) were changed to HD for 2 weeks and then back to HDF for another 2 weeks. POx was measured at baseline, pre-, mid-, and postdialysis, and 2 hours after completion of the treatment session.ResultsBaseline POx for all patients averaged 28.0 ± 7.0 μmol/l. Intradialytic POx reduction was approximately 90% and was not significantly different between groups or treatment modes [F(1) = 0.63; P = 0.44]. Mean postdialysis POx concentrations were 3.3 ± 1.8 μmol/l. A rebound of 2.1 ± 1.9 μmol/l was observed within 2 hours after dialysis. After receiving 2 weeks of the respective treatment, predialysis POx concentrations on HD did not differ significantly from those on HDF [F(1) = 0.21; P = 0.66]. Extended treatment time did not provide any added benefit [F(1) = 0.76; P = 0.40].DiscussionIn contrast to earlier observations, our data did not support a benefit of HDF over HD for POx reduction. With new technologies evolving, our results emphasized the need to carefully reevaluate and update traditional therapeutic regimens for optimized uremic toxin removal, including those used for oxalate.

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Plasma oxalate concentration and oxalate distribution volume in patients with normal and decreased renal function

Cited by 21 publications

References 19 publications

Oxalate Measurement in the Picomol Range by Ion Chromatography: Values in Fasting Plasma and Urine of Controls and Patients with Idiopathic Calcium Urolithiasis

Oxalate Measurement in the Picomol Range by Ion Chromatography: Values in Fasting Plasma and Urine of Controls and Patients with Idiopathic Calcium Urolithiasis

Oxalate, inflammasome, and progression of kidney disease

Impact of Regular or Extended Hemodialysis and Hemodialfiltration on Plasma Oxalate Concentrations in Patients With End-Stage Renal Disease

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