scholarly journals The Variability and Dietary Dependence of Urinary Oxalate Excretion in Recurrent Calcium Stone Formers

1987 ◽  
Vol 24 (4) ◽  
pp. 385-390 ◽  
Author(s):  
J M Brown ◽  
G Stratmann ◽  
D M Cowley ◽  
B M Mottram ◽  
A H Chalmers
Keyword(s):  
Calcium Intake ◽  
Normal Subjects ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Calcium Excretion ◽  
Urinary Oxalate ◽  
Calcium Stone ◽  
Oxalate Excretion ◽  
Stone Formers ◽  
Urinary Oxalate Excretion

Twenty-two recurrent calcium stone formers had 24-h urinary oxalate excretions on their home diets which were significantly greater than those of 30 normal subjects (0·48±0·23 mmol/d; mean±SD compared with 0·31±0·11; P<0·01). The stone formers also demonstrated marked day to day variability in oxalate excretion indicating that a single normal urinary oxalate measurement did not exclude significant hyperoxaluria at other times. On a hospital diet containing 1000 mg calcium per day, urinary oxalate excretion fell significantly from 0·48±0·23 mmol/d to 0·32±0·12; P<0·01. As the urinary calcium excretion in and out of hospital was similar, it seems unlikely that low calcium intake at home was responsible for the hyperoxaluria. All patients had recurrent symptomatic stone disease and had been advised to avoid foods rich in oxalate. Whilst poor compliance is a possible explanation for the variability in oxalate excretion, we believe it is more likely that there is an inadvertent intake of oxalogenic precursors in their diet. As normal subjects do not demonstrate hyperoxaluria on similar home diets, stone formers may have a metabolic defect in the handling of these precursors.

Hyperoxaluria in Idiopathic Calcium Stone Disease: Further Evidence of Intestinal Hyperabsorption of Oxalate

1982 ◽  
Vol 63 (4) ◽  
pp. 381-385 ◽  
Author(s):  
M. Marangella ◽  
B. Fruttero ◽  
M. Bruno ◽  
F. Linari
Keyword(s):  
Intestinal Absorption ◽  
Direct Relationship ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Calcium Excretion ◽  
Calcium Stone ◽  
Oxalate Excretion ◽  
Oxalate Absorption ◽  
Stone Formers ◽  
Kinetics Of

1. Seventeen healthy controls and 63 patients with idiopathic calcium stone disease of the urinary tract were investigated for urinary calcium and oxalate excretion and for [14C]oxalate intestinal absorption. 2. Under comparable controlled dietary intake a significant increase in calcium excretion was found in patients with stone disease. Oxalate excretion and [14C]oxalate intestinal absorption were mildly but not significantly increased. When patients with stone disease were subdivided into normocalciuric and hypercalciuric subjects, oxalate excretion and [14C]oxalate absorption were significantly increased in the latter. There was a significant direct relationship between calcium excretion and both oxalate excretion and [14C]oxalate absorption. 3. [14C]Oxalate absorption increased significantly in 22 stone-formers when dietary calcium was changed from normal to low. 4. The kinetics of [14C]oxalate intestinal absorption showed that the main difference between normocalciuric and hypercalciuric subjects occurred within the first 6 h after the oxalate-labelled meal. 5. These results confirm that mild hyperoxaluria is a frequent feature of idiopathic calcium stone disease even when patients and controls are studied under controlled dietary conditions. Our data are consistent with the hypothesis that hyperoxaluria is secondary to calcium hyperabsorption and is upper intestinal in origin.

scholarly journals Effect of calcium intake on urinary oxalate excretion in calcium stone-forming patients

2002 ◽  
Vol 35 (6) ◽  
pp. 669-675 ◽  
Author(s):  
J.L. Nishiura ◽  
L.A. Martini ◽  
C.O.G. Mendonça ◽  
N. Schor ◽  
I.P. Heilberg
Keyword(s):  
Calcium Intake ◽  
Urinary Oxalate ◽  
Calcium Stone ◽  
Oxalate Excretion ◽  
Urinary Oxalate Excretion

scholarly journals Association of urinary sex steroid hormones with urinary calcium, oxalate and citrate excretion in kidney stone formers

2020 ◽  
Author(s):  
Daniel G Fuster ◽  
Gaétan A Morard ◽  
Lisa Schneider ◽  
Cedric Mattmann ◽  
David Lüthi ◽  
...  
Keyword(s):  
Calcium Oxalate ◽  
Kidney Stone ◽  
Urinary Calcium ◽  
Sex Hormone ◽  
Urinary Oxalate ◽  
Oxalate Excretion ◽  
Stone Formers ◽  
17Β Estradiol ◽  
Urinary Citrate ◽  
Urinary Oxalate Excretion

Abstract Background Sex-specific differences in nephrolithiasis with respect to both distribution of prevalence and stone composition are widely described and may be influenced by sex hormones. Methods We conducted a cross-sectional analysis of the relationship between 24-hour urinary sex hormone metabolites measured by gas chromatography–mass spectrometry with urinary calcium, oxalate and citrate excretion in a cohort of 628 kidney stone formers from a tertiary care hospital in Switzerland, taking demographic characteristics, kidney function and dietary factors into account. Results We observed a positive association of urinary calcium with urinary testosterone and 17β-estradiol. Positive associations of urinary calcium with dehydroepiandrosterone, 5α-DH-testosterone, etiocholanolone, androsterone, and estriol were modified by net gastrointestinal alkali absorption or urinary sulfate excretion. As the only sex hormone, dehydroepiandrosterone was inversely associated with urinary oxalate excretion in adjusted analyses. Urinary citrate correlated positively with urinary testosterone. Associations of urinary citrate with urinary androsterone, 17β-estradiol and estriol were modified by urinary sulfate or sodium, or by sex. Conclusions Urinary androgens and estrogens are significantly associated with urinary calcium and citrate excretion, and associations are in part modified by diet. Our data furthermore reveal dehydroepiandrosterone as a novel factor associated with urinary oxalate excretion in humans.

Possible link between vitamin D and hyperoxaluria in patients with renal stone disease

1993 ◽  
Vol 84 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Sandro Giannini ◽  
Martino Nobile ◽  
Rocco Castrignano ◽  
Tecla Pati ◽  
Andrea Tasca ◽  
...  
Keyword(s):  
Vitamin D ◽  
Urinary Calcium ◽  
Calcium Excretion ◽  
Urinary Oxalate ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
Stone Formers ◽  
Group 2 ◽  
Urinary Oxalate Excretion ◽  
Group 1

1. Vitamin D seems to play an essential role in the pathogenesis of idiopathic hypercalciuria at least in part via intestinal hyperabsorption of calcium. Hyper-absorption of calcium, in turn, might enhance the intestinal uptake of free oxalate, thus leading to hyperoxaluria. To verify this hypothesis we studied 75 calcium-stone-formers subdivided as follows: group 1 (15 patients) with isolated hyperoxaluria; group 2 (25 patients) with hyperoxaluria and hypercalciuria; group 3 (22 patients) with isolated hypercalciuria; group 4 (12 patients) with no metabolic abnormalities. 2. As expected, urinary calcium excretion differed in the various groups (P < 0.001), being highest in groups 2 and 3; urinary oxalate excretion, by definition highest in groups 1 and 2, was even more pronounced in group 2 than in group 1 (P < 0.05). Although in the normal range, the serum 1,25-dihydroxyvitamin D concentration was higher (P < 0.001) in the two hypercalciuric groups (2 and 3), showing peak levels in group 2. 3. When the data from the 75 stone-formers were pooled, there was a positive correlation between the serum concentration of 1,25-dihydroxyvitamin D and urinary calcium excretion (P < 0.001) and urinary oxalate excretion (P < 0.003), the latter relationship also being present when only the two hypercalciuric groups (groups 2 and 3) were considered together (P < 0.05). 4. Our data seem to confirm a relevant role for the vitamin D system in the pathogenesis of calcium nephrolithiasis due to increased intestinal calcium absorption, but also because this in turn induces a greater intestinal absorption of oxalate, thus leading to the occurrence or exacerbation of hyperoxaluria.

Effects of an oxalate load on urinary oxalate excretion in calcium stone formers

2003 ◽  
Vol 13 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Claudia de O.G. Mendonça ◽  
Ligia Araújo Martini ◽  
Alessandra Calábria Baxmann ◽  
José Luiz Nishiura ◽  
Lilian Cuppari ◽  
...  
Keyword(s):  
Urinary Oxalate ◽  
Calcium Stone ◽  
Oxalate Excretion ◽  
Stone Formers ◽  
Urinary Oxalate Excretion

MO113CALCULATED URINARY CALCIUM-OXALATE SATURATION (ßCAOX) IS NOT SPECIFICALLY ELEVATED IN PATIENTS WITH PRIMARY HYPEROXALURIA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Bernd Hoppe ◽  
Wolfgang Böhm ◽  
Cristina Martin Higueras
Keyword(s):  
Calcium Oxalate ◽  
Primary Hyperoxaluria ◽  
Urinary Calcium ◽  
Stone Disease ◽  
Urinary Calcium Excretion ◽  
Urine Specimen ◽  
Calcium Excretion ◽  
Stone Formers ◽  
Enzyme Defects ◽  
Urinary Oxalate Excretion

Abstract Background and Aims In the primary hyperoxalurias (PH; types 1-3) recurrent urolithiasis (UL) and/or progressive nephrocalcinosis (NC) are the clinical hallmarks. Three different enzyme defects lead to endogenous oxalate overproduction and to extremely elevated urinary oxalate excretion (UOx). Thus, it seems logical that urine is supersaturated for calcium-oxalate (CaOx). It was, hence, speculated that urinary CaOx saturation (ßCaOx), calculated by computed programs, is significantly higher as compared to that of patients with idiopathic CaOx stones. We now aimed to evaluate and calculate urinary ßCaOx in PH patients according to type, as well as in non-PH patients with UL or NC. Method The computed equilibrium program EQUIL2 was used for the calculation of ßCaOx. For this, 24 h urine specimen of 70 patients with non-PH NC (46 male, 24 female, median age 6.06 (range 0.3-31.4 years)), of 149 idiopathic CaOx UL (90/59 m/f, age 8.5 (0.1-68.6)), of 51 PH 1 patients (31/21, age 12.33 (0.8-63.8)), of 5 PH 2 patients (3/2, age 5.41 (4.3-12.9)) and of 14 PH 3 patients (8/6, age 8.5 (2.9-29.3)) were analyzed for all necessary components. All patients were in stable kidney function (eGFR &gt; 45 ml/min). Results Uox was higher in the PH patients as compared to the non-PH UL or NC patients (p &lt; 0.05). However, there was no statistical difference between the Uox in PH 1 vs PH 2 or PH 3 patients, although, a clear effect of B6 medication was visible in PH1 patients. Urinary calcium excretion was lower (not significant) in PH patients as compared to NC/UL. There was no difference in ßCaOx when PH were compared to non-PH patients and it mostly remained in the normal range. Conclusion Urine ßCaOx is similar in PH and non-PH stone formers. Therefore, calculation of ßCaOx using computed programs is not a reliable parameter to define the definitively extreme CaOx supersaturation of urine from PH patients. This miscalculation is related to a rather lowish urinary calcium excretion in PH as compared to other UL/NC patients. Therefore, we recommend not to use such programs to express the risk of recurrent stone disease or nephrocalcinosis in PH.

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