Original Article

Pediatric Nephrology

, Volume 27, Issue 7, pp 1103-1109

Enteric hyperoxaluria, recurrent urolithiasis, and systemic oxalosis in patients with Crohn’s disease

  • Renate HueppelshaeuserAffiliated withDivision of Pediatric Nephrology, Department of Pediatric and Adolescent Medicine, University Hospital Cologne
  • , Gerd E. von UnruhAffiliated withDepartment of Internal Medicine I, University Hospital Bonn
  • , Sandra HabbigAffiliated withDivision of Pediatric Nephrology, Department of Pediatric and Adolescent Medicine, University Hospital Cologne
  • , Bodo B. BeckAffiliated withInstitute of Human Genetics, University Hospital Cologne
  • , Stephan BuderusAffiliated withDepartment of Pediatrics, Marien-Hospital Bonn
  • , Albrecht HesseAffiliated withDivision of Experimental Urology, Department of Urology, University Hospital Bonn
  • , Bernd HoppeAffiliated withDivision of Pediatric Nephrology, Department of Pediatric and Adolescent Medicine, University Hospital Cologne Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Background

Prevalence of recurrent calcium-oxalate (CaOx) urolithiasis (UL) is up to fivefold higher in Crohn’s disease than in the general population. Treatment options are scarce and the risk of recurrent UL or progressive renal CaOx deposition, (oxalosis) based early end-stage renal failure (ESRF), subsequent systemic oxalosis, and recurrence in the kidney graft is pronounced. We aimed to find proof that secondary hyperoxaluria is the main risk factor for the devastating course and correlates with intestinal oxalate absorption.

Methods

24-h urines were collected and analyzed for urinary oxalate (Uox) in 27 pediatric (6–18 years) and 19 adult patients (20–62 years). In the 21 patients (8 adults and 13 children) with hyperoxaluria a [13C2]oxalate absorption test was performed under standardized dietary conditions.

Results

Mean Uox was significantly higher in patients with UL or oxalosis (0.92 ± 0.57) compared with those without (0.53 ± 0.13 mmol/1.73 m2/24 h, p<0.05, normal < 0.5). Hyperoxaluria then significantly correlated with intestinal oxalate absorption (p< 0.05).

Conclusion

As UL/oxalosis has major implications for the general health in patients with Crohn’s disease (ESRF and systemic oxalosis), new medication, e.g. to reduce intestinal oxalate absorption, is definitely needed.

Keywords

Crohn’s disease Urolithiasis Secondary hyperoxaluria Systemic oxalosis Renal failure