The determination of oxalate in haemodialysate and plasma: A means to detect and study ‘hyperoxaluria’ in haemodialysed patients

Wolthers, B.G.; Meijer, S; Tepper, T.; Hayer, M.; Elzinga, Harmke

doi:10.1042/cs0710041

Cited by 28 publications

(4 citation statements)

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“…Plasma oxalate levels determined by our IC procedure are in fairly good agreement with those from some recent reports [12,17,28] performed by different techniques, but appear somehow different from others [10,11,16]. Since reliability of the results crucially relies on oxalate assay, much attention was payed to optimize this procedure.…”

Section: Discussionsupporting

confidence: 75%

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Marangella¹,

Petrarulo²,

Mandolfo

et al. 1992

Nephron

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Regular dialysis treatment (RDT) does not obviate hyperoxalemia of chronic renal failure (CRF). However, there is emerging evidence suggesting that current dialysis prescription is not always associated to progressive oxalate accumulation. In view of the controversy still concerning this issue, we have investigated on plasma profiles and dialysis kinetics of oxalate in patients on RDT. Oxalate was determined by ion chromatography on serum ultrafiltrates and on the whole dialyzate in 23 stable patients on RDT for end-stage renal failure unrelated to primary hyperoxaluria. Nine patients were on traditional hemodialysis (HD) and 14 on soft hemodiafiltration (HDF). Dialysis prescription was set so as to obtain similar KT/V of urea. Mean dialyzer clearance of oxalate (Kd_Ox) was calculated by standard procedures and was compared to urea (Kd_Urea) and creatinine (Kd_Cr) clearances. Oxalate removal was measured on the whole spent dialyzate. Distribution volume of oxalate (V_Ox) was estimated by assuming a single-pool model and was used to estimate the oxalate appearance rate (OxAR). Plasma profiles showed that dialysis patients were virtually always hyperoxalemia However, the threshold of supersaturation for calcium oxalate was exceeded in only 13 of 138 (9.4%) assayed ultrafiltrates, 13% on HD and 7.1% on HDF. Dialysis reduced plasma oxalate by more than 60%. There was a postdialysis oxalate rebound averaging 9.6% at 30 min from the end of dialysis. Plasma oxalate predialysis was independent of sex, age and time on dialysis. Kd_Ox was mildly higher on HDF than on HD, and was lower than both Kd_Urea and Kd_Cr, irrespective of the dialysis technique. Estimated V_Ox was 21.5 litres, that is 37.3% of dry body weight, and was quite similar to estimates obtained in normal subjects and in patients with CRF by alternative isotope dilution methods. OxAR averaged 337 ± 69 μmol/24 h and was not different from the daily oxalate excretion assessed in 40 healthy subjects by the same oxalate assay. OxAR was independent of sex, age and body weight and was significantly related to urea generation and protein catabolic rates. From our results we conclude that, unless the metabolic generation of oxalate is increased, current dialysis programs should prevent progressive oxalate accumulation in the majority of the patients.

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Section: Discussionsupporting

confidence: 75%

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Marangella¹,

Petrarulo²,

Mandolfo

et al. 1992

Nephron

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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.…”

contrasting

confidence: 45%

Plasma Oxalate in Chronic Renal Failure and Normal Subjects: Methodological Problems

Mees¹,

Boer²

1988

Nephron

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“…After derivatization with o -phenylenediamine in combination with acetylation, no peak for oxalic acid was observed. Both iso- and n -propanol derivatization ,− showed unexplained spectra for the isotope labeled compounds of interest.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a New Gas Chromatography–Tandem Mass Spectrometry Method for the Measurement of Enrichment of Glyoxylate Metabolism Analytes in Hyperoxaluria Patients Using a Stable Isotope Procedure

et al. 2019

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Primary hyperoxalurias (PH) are inborn errors of glyoxylate metabolism characterized by an increase in endogenous oxalate production. Oxalate overproduction may cause calcium-oxalate crystal formation leading to kidney stones, nephrocalcinosis, and ultimately kidney failure. Twenty-four hour urine oxalate excretion is an inaccurate measure for endogenous oxalate production in PH patients and not applicable in those with kidney failure. Treatment efficacy cannot be assessed with this measure during clinical trials. We describe the development and validation of a gas chromatography−tandem mass spectrometry method to analyze the samples obtained following a stable isotope infusion protocol of 13 C 2 -oxalate and 1-13 C-glycolate in both healthy individuals and PH patients. Isotopic enrichments of plasma oxalate, glycolate, and glyoxylate were measured on a gas chromatography−triple quadrupole mass spectrometry system using ethylhydroxylamine and N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide (MTBSTFA) for analyte derivatization. Method precision was good for oxalate and glycolate (coefficients of variation [CV] were <6.3% and <4.2% for inter-and intraday precision, respectively) and acceptable for glyoxylate (CV <18.3% and <6.7% for inter-and intraday precision, respectively). The enrichment curves were linear over the specified range. Sensitivity was sufficient to accurately analyze enrichments. This new method allowed calculation of kinetic features of these metabolites, thus enabling a detailed analysis of the various pathways involved in glyoxylate metabolism. The method will further enhance the investigation of the metabolic PH derangements, provides a tool to accurately assess the therapeutic efficacy of new promising therapeutic interventions for PH, and could serve as a clinical tool to improve personalized therapeutic strategies.

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The determination of oxalate in haemodialysate and plasma: A means to detect and study ‘hyperoxaluria’ in haemodialysed patients

Cited by 28 publications

References 0 publications

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Plasma Oxalate in Chronic Renal Failure and Normal Subjects: Methodological Problems

Development and Validation of a New Gas Chromatography–Tandem Mass Spectrometry Method for the Measurement of Enrichment of Glyoxylate Metabolism Analytes in Hyperoxaluria Patients Using a Stable Isotope Procedure

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