Renal Oxalate Handling in Normal Subjects and Patients with Idiopathic Renal Lithiasis: Primary and Secondary Hyperoxaluria

Wilson, Daniel M.; Smith, Lloyd H.; Erickson, Stephen B.; Torres, Vicente E.; Liedtke, Robert R.

doi:10.1007/978-1-4899-0873-5_138

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…Nine studies published within the last two decades (1984-2005) support our results, as plasma oxalate levels obtained in adults using enzymatic method (oxalate oxidase) were similar to those determined in our studied participants aged older than 1 year [24,25,28,35,38,40,42,43,63]. The determination of plasma oxalate based on different methodological approaches in adult populations also provided similar outcomes [21,27,32,34,36,37,39,41,44,64].…”

Section: Discussionsupporting

confidence: 93%

Reference values of plasma oxalate in children and adolescents

et al. 2008

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Oxalate homeostasis is a derivative of absorption and transportation in the digestive system and renal/intestinal excretion of oxalate. The objective of this cross-sectional study was to determine normative values of plasma oxalate in relation to age, gender, and body size. A group of 1,260 healthy Caucasian children and adolescents aged 3 months to 18 years [mean +/- standard deviation (SD) 10.5 +/- 4.3] was studied. Each 1-year group comprised 70 subjects. Oxalate levels were assessed in blood plasma samples obtained from fasted individuals using the precipitation-enzymatic method with oxalate oxidase. Median oxalate levels in healthy infants was 3.20 micromol/L (5th-95th percentiles: 1.56-5.58) and was higher compared with older children [2.50 micromol/L (5th-95th percentiles: 0.95-5.74); p < 0.01]. No differences were found in plasma oxalate levels between boys and girls. There were no associations between plasma oxalate levels and anthropometric traits. In the healthy population aged 1-18 years, plasma oxalate concentration is independent of age, gender, and body size. Infants demonstrate higher plasma oxalate levels compared with older children, which suggests possible immature mechanisms of renal excretion. This study appears to be the first extensive report providing normative data for plasma oxalate in children and adolescents.

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Section: Discussionsupporting

confidence: 93%

Reference values of plasma oxalate in children and adolescents

et al. 2008

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“…The bidirectional transport of oxalate seems to be part of the water absorption in the PT [85] and DT [86]. Studies using ion chromatography for oxalate measurement, however, show an average fractional excretion of 0.84 in male normals, suggesting net reabsortion of oxalate [75,88] and values of 1.12 and 1.23-1. 43 in female normals and various groups of stone formers, respectively.…”

Section: Intratubular Conditionsmentioning

confidence: 84%

Intratubular crystallization events

Kok¹

1997

World J Urol

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Can urolithiasis start as an intratubular event? Under severe hyperoxaluric conditions in animal models at least crystal formation can. Recently models have been presented that assess the chances of crystal formation under more normal conditions. These models describe changes in fluid composition as this passes through the nephron, these conditions being simulated in in vitro experiments. It appears that under naturally occurring intratubular conditions calcium-salt crystallization takes place within the time tubular fluid normally spends in the nephron. Precipitation starts with a calcium-phosphate phase under conditions found in the thin lambs. This crystalline phase then (partly) dissolves when collecting duct conditions are used, thereby inducing formation of calcium oxalates. Under these conditions the latter increase in size by way of crystal growth and agglomeration. Large particle formation and cell adhesion can eventually result in particle retention and subsequent stone formation. Viewing urolithiasis as originally an intratubular event has consequences for in vitro experiments and treatments, which are discussed in this paper.

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“…Using these methods, two groups have reported that the fractional urinary excretion of oxalate is higher in ICON with mild hyperoxaluria than in normal subjects [3,8]. This had not been possible until recently.…”

Section: Abnormal Renal Oxalate Handlingmentioning

confidence: 99%

Oxalate and urolithiasis

Sutton¹

1997

The Management of Lithiasis

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The importance of oxalic acid in medicine derives from the extreme insolubility of its calcium salt in water, at around 12 mg or 0.13 mM per litre, which is affected little by pH above 5, but increases as the pH falls below 5 [I]. Because calcium and oxalate require to be excreted in substantial quantities by the kidneys, averaging 4-5 mM and 0.3 mM per day respectively in the adult, urinary supersaturation with calcium oxalate is the norm. Complex and elaborate mechanisms exist to prevent the formation, growth and agglomeration of crystals in the urinary tract. processes which are believed to be precursors of stone formation.Calcium oxalate is the major constituent of over 70% of upper urinary tract stones. In calcium-containing stones, oxalate is most commonly the major anion, with varying amounts of calcium phosphate. Pure calcium oxalate stones are common, whereas predominantly calcium phosphate stones are less frequent « 10%). It has generally been assumed that the determination of the relative amounts of oxalate versus phosphate in idiopathic calcium stones is of little clinical value. Gault et al. [2], using a semiquantitative infrared analytical method [3 J, have recently addressed this issue in detail, and found that phosphate stones (oxalate: phosphate ratio < I) are commoner in females, tend to be larger than predominantly oxalate stones (oxalate: phosphate> 10), and in about 250/c of patients are associated with a defect in urinary acidification. These patients did not have complete distal renal tubular acidosis, and most did not have hypocitraturia. It is unclear whether these patients should receive different therapy from the commoner idiopathic calcium oxalate stone former [4]. Aside from these idiopathic calcium phosphate stone formers, calcium phosphate stones are usual in complete distal renal tubular acidosis (RTA), and are common (though less so than calcium oxalate) in primary hyperparathyroidism [5]. Sources of urinary oxalateIt is generally stated that in normal man, some 40% of urinary oxalate is derived from serine and glycine via glyoxylate, 40% from ascorbic acid via as yet uncertain metabolic intermediates, and 5-10% from dietary oxalate. An average (Western) 1. Talati et al. (eds) The Manar;ement of Lithiasis. 57-68

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Renal Oxalate Handling in Normal Subjects and Patients with Idiopathic Renal Lithiasis: Primary and Secondary Hyperoxaluria

Cited by 6 publications

References 5 publications

Reference values of plasma oxalate in children and adolescents

Reference values of plasma oxalate in children and adolescents

Intratubular crystallization events

Oxalate and urolithiasis

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