Plasma Oxalate Concentration in Chronic Renal Disease

Boer, P. de; Leersum, Leo van; Hené, Ronald J.; Mees, E. J. Dorhout

doi:10.1016/s0272-6386(84)80058-x

Cited by 36 publications

(10 citation statements)

References 12 publications

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“…Values are mean±SEM. The known thermodynamic solubility product (4) of calcium oxalate at equilibrium (2.25 X 10-M2, see Finlayson [25]) is shown as a horizontal line. *Differs from all other groups, P < 0.01, and less than 4, P < 0.01.…”

Section: Supersaturation Measurementsmentioning

confidence: 99%

“…Serum oxalate concentration increases during chronic renal failure (1,2), and is above normal in virtually all patients who require chronic dialysis (3)(4)(5), because oxalate is removed from the body almost entirely by filtration at the renal glomerulus (6)(7)(8) and by secretion in the early portions of the proximal tubules (9-1 1). In some patients with chronic renal failure, crystals of calcium oxalate have been identified in kidney, blood vessels, myocardium, thyroid, synovia, cartilage, bone, and periodontium (12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evidence that serum calcium oxalate supersaturation is a consequence of oxalate retention in patients with chronic renal failure.

Worcester¹,

Nakagawa²,

Bushinsky³

et al. 1986

J. Clin. Invest.

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Serum oxalate rises in uremia because of decreased renal clearance, and crystals ofcalcium oxalate occur in the tissues of uremic patients. Crystal formation suggests that either uremic serum is supersaturated with calcium oxalate, or local oxalate production or accumulation causes regional supersaturation. To test the first alternative, we ultrafiltered uremic serum and measured supersaturation with two different methods previously used to study supersaturation in urine. First, the relative saturation ratio (RSR), the ratio of the dissolved calcium oxalate complex to the thermodynamic calcium oxalate solubility product, was estimated for 11 uremic (before and after dialysis) and 4 normal serum samples using a computer program. Mean ultrafiltrate oxalate predialysis was 89±8 ,uM/liter (±SEM), 31±4 postdialysis, and 10±3 in normals. Mean RSR was 1.7±0.1 (predialysis), 0.7±0.1 (postdialysis), and 0.2±0.1 (normal), where values >1 denote supersaturation, <1, undersaturation. Second, the concentration product ratio (CPR), the ratio of the measured calcium oxalate concentration product before to that after incubation of the sample with calcium oxalate monohydrate crystal, was measured in seven uremic and seven normal serum ultrafiltrates. Mean oxalate was 91±11 (uremic) and 8±3 (normal). Mean CPR was 1.4±0.2 (uremic) and 0.2±0.1 (normal). Predialysis, 17 of 18 uremic ultrafiltrates were supersaturated with respect to calcium oxalate. The degree of supersaturation was correlated with ultrafiltrate oxalate (RSR, r = 0.99, n = 29, P < 0.001; CPR, r = 0.75, n = 11, P < 0.001). A value of ultrafiltrate oxalate of 50 AM/liter separated undersaturated from supersaturated samples and occurred at a creatinine of -9.0 mg/dl.

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Section: Supersaturation Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evidence that serum calcium oxalate supersaturation is a consequence of oxalate retention in patients with chronic renal failure.

Worcester¹,

Nakagawa²,

Bushinsky³

et al. 1986

J. Clin. Invest.

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show abstract

“…Frequent determinations of oxalate and aggressive dialysis are necessary until kidney and/or liver transplantation can be performed (14 ). Plasma oxalate concentrations are increased in all patients with end-stage renal failure, regardless of the cause, although not to the extent seen in primary hyperoxaluria (21 ). Individuals with diverse gastrointestinal conditions that cause fat malabsorption often overabsorb oxalate from their diet (22)(23)(24)(25), a condition termed enteric hyperoxaluria.…”

mentioning

confidence: 99%

Sensitive Spectrophotometric Assay for Plasma Oxalate

et al. 2005

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“…None of these studies are cited or discussed by the authors. Their findings in pathologic conditions, such as the normal va lues in far advanced renal insufficiency, the influence of protein restriction, and the 'rapid fall of plasma oxalate to near normal values during dialysis' are at variance with recently published data [4][5][6] and cannot be accepted on methodological grounds. Therefore, the validity on the authors conclusions is a least questionable.…”

mentioning

confidence: 74%