The Effectiveness of Hemodialysis and Continuous Ambulatory Peritoneal Dialysis (CAPD) in Controlling Plasma Oxalate Concentrations

Fituri, N.; Keogh, Brian; Costello, J.

doi:10.1007/978-1-4684-7272-1_88

Cited by 2 publications

(2 citation statements)

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“…In these patients, regular dialysis treatment (RDT) does not permit to remove newly gene rated oxalate, and systemic oxalosis invariably developes [7], The issue of systemic oxalosis in patients on RDT for diseases unrelated to primary hyperoxaluria, i.e., in the absence of oxalate overproduction, is still controversial. A num ber of studies on plasma oxalate profiles in patients on RDT have been published so far [8][9][10][11][12], Flowever, taken as a whole, the results are in poor agreement with each other, since most of these studies involved a small num ber o f patients, plasma oxalate was measured by different procedures and the patients were being treated by different dialysis techniques. Anyway, it is widely agreed that RDT permits to reduce the oxalate burden but not to restore plasma oxalate to normal [8][9][10][11], Predialysis plasma samples have been found to be super saturated with respect to calcium oxalate [10], Tissue oxalate accumulation has been measured by the l4C-oxalate technique in few patients on either RDT or perito neal dialysis [11], The rate o f oxalate appearance has been found to be increased in dialysis patients [12].…”

Section: Introductionmentioning

confidence: 87%

“…A num ber of studies on plasma oxalate profiles in patients on RDT have been published so far [8][9][10][11][12], Flowever, taken as a whole, the results are in poor agreement with each other, since most of these studies involved a small num ber o f patients, plasma oxalate was measured by different procedures and the patients were being treated by different dialysis techniques. Anyway, it is widely agreed that RDT permits to reduce the oxalate burden but not to restore plasma oxalate to normal [8][9][10][11], Predialysis plasma samples have been found to be super saturated with respect to calcium oxalate [10], Tissue oxalate accumulation has been measured by the l4C-oxalate technique in few patients on either RDT or perito neal dialysis [11], The rate o f oxalate appearance has been found to be increased in dialysis patients [12]. These results have been taken as supporting the view that systemic secondary oxalosis is a frequent feature of dialyzed patients [13,14].…”

Section: Introductionmentioning

confidence: 87%

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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: Introductionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 87%

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Marangella¹,

Petrarulo²,

Mandolfo

et al. 1992

Nephron

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Oxalate elimination via hemodialysis or peritoneal dialysis in children with chronic renal failure

Höppe

Graf

Offner

et al. 1996

Pediatric Nephrology

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Oxalate elimination and oxalate dialysance via hemodialysis (HD) or peritoneal dialysis (CAPD) has not been studied in detail in pediatric patients. We studied plasma oxalate, oxalate elimination, and oxalate dialysance in 15 infants and children undergoing CAPD (9 female, 6 male, aged 9 months to 18 years) and in 10 children on HD (4 female, 6 male, aged 7-18 years). Two children in each group had primary hyperoxaluria (PH). The mean duration of dialysis prior to examination was 12 +/- 11 months in CAPD and 31 +/- 23 months in HD patients. Bicarbonate HD was performed 5 h three times a week, CAPD consisted of five daily exchanges in 5 patients and four changes in the remaining 10 children (dwell volume 40 ml/kg body weight, 2.3 g/l glucose). Although oxalate dialysance was significantly higher in HD (mean 115.6 ml/ min per 1.73 m2 in HD versus 7.14 ml/min in CAPD), mean oxalate elimination per week was not different between both renal replacement therapies (3,478 mumol/1.73 m2 surface area/week in CAPD versus 3,915 mumol/1.73 m2 per week in HD). Oxalate elimination in patients with PH was between 6,650 and 9,900 mumol/week. Plasma oxalate remained elevated in both procedures [28-84 mumol/l in CAPD (92/148 in PH) and 33-101 mumol/l in HD (70/93 in PH)]. Oxalate elimination can be increased by a more frequent hemodialysis regimen.

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The Effectiveness of Hemodialysis and Continuous Ambulatory Peritoneal Dialysis (CAPD) in Controlling Plasma Oxalate Concentrations

Cited by 2 publications

References 5 publications

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Plasma Profiles and Dialysis Kinetics of Oxalate in Patients Receiving Hemodialysis

Oxalate elimination via hemodialysis or peritoneal dialysis in children with chronic renal failure

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