Plasma Oxalate in Patients With Chronic Renal Failure Receiving Continuous Ambulatory Peritoneal Dialysis or Hemodialysis

Plasma oxalate levels in prevalent hemodialysis patients and potential implications for ascorbic acid supplementation

“…The consistency of pre-HD P[Ox] comes into question. Within 48 h post-HD, McConnell et al noted in 20 patients that P[Ox] was at 95% of the original pre-HD P[Ox] [17]. We have also observed that in a small subset of 8 patients that mean pre-HD P[Ox] was not different before two consecutive treatments (unpublished data).…”

“…Mean pre-HD P[Ox] was 22.3 μM; lower than the levels of 39-49.8 μM that were seen in older series when patients received less efficient HD [14,17,19,20]. The majority of prevalent HD patients now have a pre-HD P[Ox] b30 μM, a level above which oxalate may begin to deposit pathologically in organs, due in large part to calcium-oxalate supersaturation in the blood.…”

“…These precipitates may then deposit pathologically in organs [15], leading to secondary oxalosis [16]. HD [17] and peritoneal dialysis [18] provide alternative routes of Ox elimination. However, even when receiving 100 mg or less of AA/day, HD patients in previous studies could attain a P[Ox] of 30 μM or higher [17,[19][20][21].…”

“…HD [17] and peritoneal dialysis [18] provide alternative routes of Ox elimination. However, even when receiving 100 mg or less of AA/day, HD patients in previous studies could attain a P[Ox] of 30 μM or higher [17,[19][20][21]. Studies to evaluate this potential of oxalosis developing were performed before the adoption of current dialysis adequacy targets and before the use of high-flux dialyzers.…”

Modulation of NADPH oxidase activity by known uraemic retention solutes

“…The maximum uraemic plasma concentration of oxalate in patients with CKD (7Á6 mg/L) is 25 times higher than it is in healthy subjects (0Á3 mg/L) [39]. The maximum uraemic plasma concentration of oxalate in patients with CKD (7Á6 mg/L) is 25 times higher than it is in healthy subjects (0Á3 mg/L) [39].…”