Secondary oxalosis due to excess vitamin C intake: A cause of graft loss in a renal transplant recipient

Yaïch, S.; Chaabouni, Y.; Charfeddine, K.; Zaghdane, S; Kharrat, M.; Kammoun, K.; Makni, S.; Boudawara, Tahia; Hachicha, J.

doi:10.4103/1319-2442.124518

Cited by 17 publications

(13 citation statements)

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“…All patients received hydration and dietary interventions, including the adoption of a normal calcium, low-oxalate diet. In addition, the use of diuretics for fluid overload, 15 , 46 , 70 alkali therapy to alkalinize the urine, 10 , 19 , 46 , 53 and pyridoxine to convert glyoxalate (the main precursor of oxalate) to glycine 15 , 19 , 44 , 48 , 65 , 70 was variably reported and had inconsistent impact on recovery of kidney function ( Supplemental Table S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…According to the European Primary Hyperoxaluria Registry, the 5-year survival rate of patients with primary hyperoxaluria is 76%, possibly due to a younger age at onset. 104 Hydration, 3 , 8 , 13 , 19 , 28 , 46 , 47 , 60 , 62 , 63 , 68 alkali therapy, 19 , 46 and pyridoxine 19 , 44 , 48 , 70 for treatment of oxalate nephropathy has yielded unsatisfactory results. Treatment of oxalate nephropathy in patients with native kidneys and kidney allografts likely depends on the underlying etiology, but low-oxalate and low-fat diets are generally recommended.…”

Section: Discussionmentioning

confidence: 99%

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Secondary Oxalate Nephropathy: A Systematic Review

Lumlertgul

Siribamrungwong

Jaber

et al. 2018

Kidney International Reports

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IntroductionLittle is known of the clinical outcomes of secondary oxalate nephropathy. To inform clinical practice, we performed a systematic review of case reports and case series to examine the clinical characteristics and outcomes of patients with secondary oxalate nephropathy.MethodsElectronic databases were searched for case reports and case series of individual cases or cohorts of patients with biopsy-proven oxalate nephropathy in native or transplanted kidneys from 1950 until January 2018.ResultsFifty-seven case reports and 10 case series met the inclusion criteria, totaling 108 patients. The case series were meta-analyzed. Mean age was 56.4 years old, 59% were men, and 15% were kidney transplant recipients. Fat malabsorption (88%) was the most commonly attributed cause of oxalate nephropathy, followed by excessive dietary oxalate consumption (20%). The mean baseline serum creatinine was 1.3 mg/dl and peaked at 4.6 mg/dl. Proteinuria, hematuria, and urinary crystals was reported in 69%, 32%, and 26% of patients, respectively. Mean 24-hour urinary oxalate excretion was 85.4 mg/d. In addition to universal oxalate crystal deposition in tubules and/or interstitium, kidney biopsy findings included acute tubular injury (71%), tubular damage and atrophy (69%), and interstitial mononuclear cell infiltration (72%); 55% of patients required dialysis. None had complete recovery, 42% had partial recovery, and 58% remained dialysis-dependent. Thirty-three percent of patients died.ConclusionSecondary oxalate nephropathy is a rare but potentially devastating condition. Renal replacement therapy is required in >50% of patients, and most patients remain dialysis-dependent. Studies are needed for effective preventive and treatment strategies in high-risk patients with hyperoxaluria-enabling conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Secondary Oxalate Nephropathy: A Systematic Review

Lumlertgul

Siribamrungwong

Jaber

et al. 2018

Kidney International Reports

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“…There have been numerous case reports in the literature of oxalate nephropathy secondary to high dose oral vitamin C intake [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. However, a number of these cases are complicated by dehydration due to diarrhoea and vomiting [ 42 , 43 ], or acute kidney injury and transplantation requiring dialysis [ 46 , 47 , 48 ]. Although no significant changes in oxalate metabolism were observed in a study involving ten end-stage renal patients who took 100 mg/day of vitamin C [ 50 ], higher doses have been associated with increased plasma oxalate levels in haemodialysis patients [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

No Reported Renal Stones with Intravenous Vitamin C Administration: A Prospective Case Series Study

Prier¹,

Carr

Baillie

2018

Antioxidants

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A few cases associating high dose intravenous vitamin C (IVC) administration with renal stone formation have been reported in the literature, however, no long-term studies investigating IVC administration and reported renal stones have been carried out. Our aim was to measure the frequency of reported renal stones in patients receiving IVC therapy. We carried out a prospective case series study of 157 adult patients who commenced IVC therapy at Integrated Health Options clinic between 1 September 2011 and 31 August 2012, with follow-up for 12 months. Inquiries into the occurrence of renal stones were conducted at enrolment, 6 and 12 months, and renal function blood tests were conducted at enrolment, 4 weeks and every 12 weeks thereafter in a subgroup of patients. No renal stones were reported by any patients in the study, despite 8% of the patients having a history of renal stones. In addition, the majority of patients investigated had stable renal function during the study period as evidenced by little change in serum creatinine levels and estimated glomerular filtration rate (eGFR) following IVC. In conclusion, IVC therapy was not associated with patient-reported renal stones. Although not the primary focus of this study, it was also observed that there was no significant change in mean serum creatinine or eGFR for those who had follow-up renal function blood tests.

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“…However, patients on hemodialysis can develop secondary oxalosis [ 161 ]. Large amounts of oxalate accumulation result in secondary oxalosis caused by an elevated ingestion, high production, or diminished excretion [ 162 ]. Calcium oxalate deposition in the kidneys and high levels of serum and urinary oxalate can be caused by the ingestion of elevated doses of vitamin C [ 143 ].…”

Section: Adverse Effects Of Antioxidant Agentsmentioning

confidence: 99%

Reductive Stress in Inflammation-Associated Diseases and the Pro-Oxidant Effect of Antioxidant Agents

Pérez-Torres

Guarner-Lans

Rubio-Ruiz

2017

IJMS

193

141

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Abstract:Reductive stress (RS) is the counterpart oxidative stress (OS), and can occur in response to conditions that shift the redox balance of important biological redox couples, such as the NAD + /NADH, NADP + /NADPH, and GSH/GSSG, to a more reducing state. Overexpression of antioxidant enzymatic systems leads to excess reducing equivalents that can deplete reactive oxidative species, driving the cells to RS. A feedback regulation is established in which chronic RS induces OS, which in turn, stimulates again RS. Excess reducing equivalents may regulate cellular signaling pathways, modify transcriptional activity, induce alterations in the formation of disulfide bonds in proteins, reduce mitochondrial function, decrease cellular metabolism, and thus, contribute to the development of some diseases in which NF-κB, a redox-sensitive transcription factor, participates. Here, we described the diseases in which an inflammatory condition is associated to RS, and where delayed folding, disordered transport, failed oxidation, and aggregation are found. Some of these diseases are aggregation protein cardiomyopathy, hypertrophic cardiomyopathy, muscular dystrophy, pulmonary hypertension, rheumatoid arthritis, Alzheimer's disease, and metabolic syndrome, among others. Moreover, chronic consumption of antioxidant supplements, such as vitamins and/or flavonoids, may have pro-oxidant effects that may alter the redox cellular equilibrium and contribute to RS, even diminishing life expectancy.

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Secondary oxalosis due to excess vitamin C intake: A cause of graft loss in a renal transplant recipient

Cited by 17 publications

References 0 publications

Secondary Oxalate Nephropathy: A Systematic Review

Secondary Oxalate Nephropathy: A Systematic Review

No Reported Renal Stones with Intravenous Vitamin C Administration: A Prospective Case Series Study

Reductive Stress in Inflammation-Associated Diseases and the Pro-Oxidant Effect of Antioxidant Agents

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