Urinary Lithogenic Risk Profile in Recurrent Stone Formers With Hyperoxaluria: A Randomized Controlled Trial Comparing DASH (Dietary Approaches to Stop Hypertension)-Style and Low-Oxalate Diets

Noori, Nazanin; Honarkar, Elaheh; Goldfarb, David S.; Kalantar-Zadeh, Kamyar; Taheri, Maryam; Shakhssalim, Nasser; Parvin, Mahmoud; Basiri, Abbas

doi:10.1053/j.ajkd.2013.11.022

Cited by 73 publications

(57 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Such approaches in subsequent studies have included short-term and not well-controlled studies [10,11,12]. Oxalate is ubiquitous in many foods in the American diet [18,19], and it is not clear that patients outside of a clinical trial can easily adhere to one of the several recommended diets that might reduce urinary oxalate, either due to availability of oxalate-free foods, lifestyle or the economic costs of using such diets [13].…”

Section: Discussionmentioning

confidence: 99%

“…To date, diets with a low oxalate, salt and protein coupled with high water intake is viewed as the primary therapy for secondary hyperoxaluria, but compliance with and effectiveness of these measures are poor [10,11,12]. Furthermore, given the ubiquity of oxalate in many healthy foods (green vegetables, nuts, chocolate, grains, fruits, etc.)…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Double-Blind, Placebo Controlled, Randomized Phase 1 Cross-Over Study with ALLN-177, an Orally Administered Oxalate Degrading Enzyme

Langman

Grujić²,

Pease³

et al. 2016

Am J Nephrol

View full text Add to dashboard Cite

Background: Hyperoxaluria may result from increased endogenous production or overabsorption of dietary oxalate in the gastrointestinal tract leading to nephrolithiasis and, in some, to oxalate nephropathy and chronic kidney disease. ALLN-177 is an oral formulation of a recombinant, oxalate specific, microbial enzyme oxalate decarboxylase intended to treat secondary hyperoxaluria by degrading dietary oxalate in the gastrointestinal tract, thereby reducing its absorption and subsequent excretion in the urine. Methods: This double-blind, placebo controlled, randomized, cross-over, phase 1 study of ALLN-177 evaluated the tolerability of ALLN-177 and its effect on urinary oxalate excretion in 30 healthy volunteers with hyperoxaluria induced by ingestion of a high oxalate, low calcium (HOLC) diet. The primary end point was the difference in the mean 24-hour urinary oxalate excretion during the ALLN-177 treatment period compared with the placebo treatment period. Results: The daily urinary oxalate excretion increased in the study population from 27.2 ± 9.5 mg/day during screening to 80.8 ± 24.1 mg/day (mean ± SD) on the HOLC diet before introducing ALLN-177 or placebo therapy for 7 days. Compared to placebo, ALLN-177 treatment reduced urinary oxalate by 11.6 ± 2.7 mg/day, p = 0.0002 (least squares mean ± SD). Conclusions: In healthy volunteers, with diet-induced hyperoxaluria treatment with ALLN-177, when compared to placebo, significantly reduced urinary oxalate excretion by degrading dietary oxalate in the gastrointestinal tract and thereby reducing its absorption. ALLN-177 may represent a new approach for managing secondary hyperoxaluria and its complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Double-Blind, Placebo Controlled, Randomized Phase 1 Cross-Over Study with ALLN-177, an Orally Administered Oxalate Degrading Enzyme

Langman

Grujić²,

Pease³

et al. 2016

Am J Nephrol

View full text Add to dashboard Cite

show abstract

“…cium oxalate in the group on the DASH diet. 125 The DASH diet included foods rich in oxalate, and further modification of the diet to reduce its oxalate content may prove more effective in improving urinary stone risk factors and ultimately stone recurrence rates.…”

Section: Follow-upmentioning

confidence: 99%

Medical management of renal stones

Morgan

Pearle

2016

BMJ

124

117

View full text Add to dashboard Cite

The prevalence of kidney stones is increasing in industrialized nations, resulting in a corresponding rise in economic burden. Nephrolithiasis is now recognized as both a chronic and systemic condition, which further underscores the impact of the disease. Diet and environment play an important role in stone disease, presumably by modulating urine composition. Dietary modification as a preventive treatment to decrease lithogenic risk factors and prevent stone recurrence has gained interest because of its potential to be safer and more economical than drug treatment. However, not all abnormalities are likely to be amenable to dietary therapy, and in some cases drugs are necessary to reduce the risk of stone formation. Unfortunately, no new drugs have been developed for stone prevention since the 1980s when potassium citrate was introduced, perhaps because the long observation period needed to demonstrate efficacy discourages investigators from embarking on clinical trials. Nonetheless, effective established treatment regimens are currently available for stone prevention.

show abstract

“…Nonetheless, dietary modifications and USD risk are areas of expanding research. For instance, the Dietary Approaches to Stop Hypertension diet (90), which is high in unrefined grains and vegetables and low in dietary fat and sodium, is associated with decreased USD risk, although this association has not been validated in a randomized, controlled trial (91).…”

Section: Preventionmentioning

confidence: 99%

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Scales

Tasian

Schwaderer

et al. 2016

CJASN

Self Cite

137

View full text Add to dashboard Cite

Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment.

show abstract

Urinary Lithogenic Risk Profile in Recurrent Stone Formers With Hyperoxaluria: A Randomized Controlled Trial Comparing DASH (Dietary Approaches to Stop Hypertension)-Style and Low-Oxalate Diets

Abstract: The DASH diet might be an effective alternative to the low-oxalate diet in reducing calcium oxalate supersaturation and should be studied more.

Cited by 73 publications

References 26 publications

A Double-Blind, Placebo Controlled, Randomized Phase 1 Cross-Over Study with ALLN-177, an Orally Administered Oxalate Degrading Enzyme

A Double-Blind, Placebo Controlled, Randomized Phase 1 Cross-Over Study with ALLN-177, an Orally Administered Oxalate Degrading Enzyme

Medical management of renal stones

Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health

Contact Info

Product

Resources

About