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Urolithiasis
Published in: Urolithiasis 1/2016

01-02-2016 | Invited Review

Lowering urinary oxalate excretion to decrease calcium oxalate stone disease

Authors: Ross P. Holmes, John Knight, Dean G. Assimos

Published in: Urolithiasis | Issue 1/2016

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Abstract

Dietary modifications should be considered as a first line approach in the treatment of idiopathic calcium oxalate nephrolithiasis. The amounts of oxalate and calcium consumed in the diet are significant factors in the development of the disease due to their impact on urinary oxalate excretion. There are a number of strategies that can be employed to reduce oxalate excretion. The consumption of oxalate-rich foods should be avoided and calcium intake adjusted to 1000–1200 mg/day. To encourage compliance it should be emphasized to patients that they be vigilant with this diet as a deviation in any meal or snack could potentially result in significant stone growth. The evidence underlying these two modifications is outlined and other strategies to reduce urinary oxalate excretion are reviewed.
Literature
1.
Curhan GC, Taylor EN (2008) 24-h uric acid excretion and the risk of kidney stones. Kid Int 73(4):489–496CrossRef
2.
Hatch M (2014) Intestinal adaptations in chronic kidney disease and the influence of gastric bypass surgery. Exper Physiol 99(9):1163–1167CrossRef
3.
Holmes RP, Ambrosius WT, Assimos DG (2005) Dietary oxalate loads and renal oxalate handling. J Urol 174(3):943–947CrossRefPubMed
4.
Taylor EN, Curhan GC (2007) Oxalate intake and the risk for nephrolithiasis. JASN 18(7):2198–2204CrossRefPubMed
5.
Holmes RP, Goodman HO, Assimos DG (2001) Contribution of dietary oxalate to urinary oxalate excretion. Kid Int 59:270–276CrossRef
6.
von Unruh GE, Voss S, Sauerbruch T, Hesse A (2003) Reference range for gastrointestinal oxalate absorption measured with a standardized [13C2] oxalate absorption test. J Urol 169:687–690CrossRef
7.
Tang M, Larson-Meyer DE, Liebman M (2008) Effect of cinnamon and turmeric on urinary oxalate excretion, plasma lipids, and plasma glucose in healthy subjects. Am J Clin Nutr 87(5):1262–1267PubMed
8.
Lemann J, Pleuss JA, Worcester EM, Hornick L, Schrab D, Hoffmann RG (1996) Urinary oxalate excretion increases with body size and decreases with increasing dietary calcium intake among healthy adults. Kid Int 49:200–208CrossRef
9.
von Unruh GE, Voss S, Sauerbruch T, Hesse A (2004) Dependence of oxalate absorption on the daily calcium intake. JASN 15(6):1567–1573CrossRef
10.
Knight J, Assimos DG, Callahan MF, Holmes RP (2011) Metabolism of primed, constant infusions of [1,2-(13)C(2)] glycine and [1-(13)C(1)] phenylalanine to urinary oxalate. Metab Clin Exp 60(7):950–956PubMedCentralCrossRefPubMed
11.
12.
Knight J, Jiang J, Assimos DG, Holmes RP (2006) Hydroxyproline ingestion and urinary oxalate and glycolate excretion. Kid Int 70(11):1929–1934CrossRef
13.
14.
Holmes RP, Hurst CH, Assimos DG, Goodman HO (1995) Glucagon increases urinary oxalate excretion in the guinea pig. Am J Physiol 269:E568–E574PubMed
15.
Poore RE, Hurst CH, Assimos DG, Holmes RP (1997) Pathways of hepatic oxalate synthesis and their regulation. Am J Physiol 272:C289–C294PubMed
16.
Holmes RP, Knight J, Assimos DA Origin of urinary oxalate. In: Evan AP, Lingeman JE, Williams JCJ (eds) Renal stone disease, Indianapolis, 2006. AIP Conference Proceedings, vol. 900, pp 176–182
17.
Taylor EN, Stampfer MJ, Curhan GC (2004) Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. JASN 15:3225–3232CrossRefPubMed
18.
Thomas LD, Elinder CG, Tiselius HG, Wolk A, Akesson A (2013) Ascorbic acid supplements and kidney stone incidence among men: a prospective study. JAMA Internal Med 173(5):386–388CrossRef
19.
20.
Baxmann AC, De OGMC, Heilberg IP (2003) Effect of vitamin C supplements on urinary oxalate and pH in calcium stone-forming patients. Kid Int 63(3):1066–1071CrossRef
21.
Nasr SH, Kashtanova Y, Levchuk V, Markowitz GS (2006) Secondary oxalosis due to excess vitamin C intake. Kid Int 70(10):1672CrossRef
22.
Traxer O, Huet B, Poindexter J, Pak CY, Pearle MS (2003) Effect of ascorbic acid consumption on urinary stone risk factors. J Urol 170(2 Pt 1):397–401CrossRefPubMed
23.
Jiang J, Knight J, Easter LH, Neiberg R, Holmes RP, Assimos DG (2011) Impact of dietary calcium and oxalate, and Oxalobacter formigenes colonization on urinary oxalate excretion. J Urol 186(1):135–139PubMedCentralCrossRefPubMed
24.
Lieske JC, Tremaine WJ, De Simone C, O’Connor HM, Li X, Bergstralh EJ, Goldfarb DS (2010) Diet, but not oral probiotics, effectively reduces urinary oxalate excretion and calcium oxalate supersaturation. Kid Int 78(11):1178–1185CrossRef
25.
Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U, Novarini A (2002) Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. NEJM 346(2):77–84CrossRefPubMed
26.
Allison MJ, Dawson KA, Mayberry WR, Foss JG (1985) Oxalobacter formigenes gen. nov., sp. nov.: oxalate-degrading anaerobes that inhabit the gastrointestinal tract. Arch Microbiol 141:1–7CrossRefPubMed
27.
Knight J, Deora R, Assimos DG, Holmes RP (2013) The genetic composition of Oxalobacter formigenes and its relationship to colonization and calcium oxalate stone disease. Urolithiasis 41(3):187–196PubMedCentralCrossRefPubMed
28.
Kaufman DW, Kelly JP, Curhan GC, Anderson TE, Dretler SP, Preminger GM, Cave DR (2008) Oxalobacter formigenes may reduce the risk of calcium oxalate kidney stones. JASN 19(6):1197–1203PubMedCentralCrossRefPubMed
29.
Siener R, Bangen U, Sidhu H, Honow R, von Unruh G, Hesse A (2013) The role of Oxalobacter formigenes colonization in calcium oxalate stone disease. Kid Int 83(6):1144–1149CrossRef
30.
Duncan SH, Richardson AJ, Kaul P, Holmes RP, Allison MJ, Stewart CS (2002) Oxalobacter formigenes and its potential role in human health. Appl Environ Microbiol 68(8):3841–3847PubMedCentralCrossRefPubMed
31.
Campieri C, Campieri M, Bertuzzi V, Swennen E, Matteuzzi D, Stefoni S, Pirovano F, Centi C, Ulisse S, Famularo G, De Simone C (2001) Reduction of oxaluria after an oral course of lactic acid bacteria at high concentration. Kid Int 60(3):1097–1105CrossRef
32.
Lange JN, Mufarrij PW, Easter L, Knight J, Holmes RP, Assimos DG (2014) Fish oil supplementation and urinary oxalate excretion in normal subjects on a low-oxalate diet. Urology 84(4):779–782PubMedCentralCrossRefPubMed
33.
Monico CG, Rossetti S, Olson JB, Milliner DS (2005) Pyridoxine effect in type I primary hyperoxaluria is associated with the most common mutant allele. Kid Int 67(5):1704–1709CrossRef
34.
Ortiz-Alvarado O, Miyaoka R, Kriedberg C, Moeding A, Stessman M, Monga M (2011) Pyridoxine and dietary counseling for the management of idiopathic hyperoxaluria in stone-forming patients. Urology 77(5):1054–1058CrossRefPubMed
35.
Holmes RP, Assimos DG (1998) Glyoxylate synthesis, and its modulation and its influence on oxalate synthesis. J Urol 160:1617–1624CrossRefPubMed
36.
Rooney CS, Randall WC, Streeter KB, Ziegler C, Cragoe EJ, Schwam H, Michelson SR, Williams HWR, Eichler E, Duggan DE, Ulm EH, Noll RM (1983) Inhibitors of glycolate oxidase. 4-Substituted 3-hydroxy-1H-pyrrole-2,5-dione derivatives. J Med Chem 26:700–714CrossRefPubMed
37.
Summitt CB, Johnson LC, Jonsson TJ, Parsonage D, Holmes RP, Lowther WT (2015) Proline dehydrogenase 2 (PRODH2) is a hydroxyproline dehydrogenase (HYPDH) and molecular target for treating primary hyperoxaluria. Biochem J 466(2):273–281CrossRefPubMed
38.
Liebman M, Costa G (2000) Effects of calcium and magnesium on urinary oxalate excretion after oxalate loads. J Urol 163(5):1565–1569CrossRefPubMed
39.
Ettinger B, Citron JT, Livermore B, Dolman LI (1988) Chlorthalidone reduces calcium oxalate calculus occurrence but magnesium hydroxide does not. J Urol 139:679–684PubMed
40.
Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, Monga M, Penniston KL, Preminger GM, Turk TM, White JR (2014) Medical management of kidney stones: AUA guideline. J Urol 192(2):316–324CrossRefPubMed
Metadata
Title
Lowering urinary oxalate excretion to decrease calcium oxalate stone disease
Authors
Ross P. Holmes
John Knight
Dean G. Assimos
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
Urolithiasis / Issue 1/2016
Print ISSN: 2194-7228
Electronic ISSN: 2194-7236
DOI
https://doi.org/10.1007/s00240-015-0839-4

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