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Hyperoxaluria and intestinal disease

The role of steatorrhea and dietary calcium in regulating intestinal oxalate absorption

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Abstract

Hyperoxaluria was documented in patients with pancreatic insufficiency, adult celiac disease, regional enteritis after ileectomy and partial colectomy, and jejunoileal bypass. The degree of hyperoxaluria correlated directly with the severity of the steatorrhea and inversely with the dietary calcium content. High-calcium diets suppressed oxalate excretion to normal when fecal fat excretion was approximatelys 30 g/day or less. In patients with more severe steatorrhea, decreasing dietary fat and oxalate content further reduced urinary oxalate excretion. These data suggest that while steatorrhea is the most important determinant for enhanced absorption of dietary oxalate, variations in dietary calcium content modulate the amount of oxalate absorbed.

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References

  1. Deren JJ, Purush JG, Levitt MF, Khelani MT: Nephrolithiasis as a complication of ulcerative colitis and regional enteritis. Ann Intern Med 56:843–853, 1962

    PubMed  Google Scholar 

  2. Gelzayd EA, Breuer RI, Kirsner JB: Nephrolithiasis in inflammatory bowel disease. Am J Dig Dis 13:1027–1034, 1968

    PubMed  Google Scholar 

  3. Dickstein SS, Frame B: Urinary tract calculi after intestinal shunt operations for the treatment of obesity. Surg Gynecol Obstet 136:257–260, 1973

    PubMed  Google Scholar 

  4. O'Leary JP, Thomas WC, Woodward ER: Urinary tract stone after small bowel bypass for morbid obesity. Am J Surg 127:142–147, 1974

    PubMed  Google Scholar 

  5. Hofmann AF, Thomas PJ, Smith LH: Pathogenesis of secondary hyperoxaluria in patients with ileal resection and diarrhea. Gastroenterology 58:960, 1970 (abstract)

    Google Scholar 

  6. Smith LH, Fromm H, Hofmann AF: Acquired hyperoxaluria, nephrolithiasis, and intestinal disease. N Engl J Med 286:1371–1375, 1972

    PubMed  Google Scholar 

  7. Admirand WH, Earnest DL, Williams HE: Hyperoxaluria and bowel disease. Trans Assoc Am Phys 84:307–312, 1971

    PubMed  Google Scholar 

  8. Dowling RH, Rose GA, Sutor DJ: Hyperoxaluria and renal calculi in ileal disease. Lancet 1:1103–1106, 1971

    PubMed  Google Scholar 

  9. Chadwick VS, Modha K, Dowling RH: Mechanism of hyperoxaluria in patients with ileal dysfunction. N Engl J Med 289:172–176, 1973

    PubMed  Google Scholar 

  10. Stauffer JQ, Humphreys MH, Weir GJ: Acquired hyperoxaluria with regional enteritis after ileal resection. Role of dietary oxalate. Ann Intern Med 79:383–391, 1973

    PubMed  Google Scholar 

  11. Earnest DL, Johnson G, Williams HE, Admirand WH: Hyperoxaluria in patients with ileal resection: An abnormality in diatary oxalate absorption. Gastroenterology 66:1114–1122, 1974

    PubMed  Google Scholar 

  12. Hofmann AF, Tacker MM, Fromm H, Thomas PJ, Smith LH: Acquired hyperoxaluria and intestinal disease. Evidence that bile acid glycine is not a precursor of oxalate. Mayo Clin Proc 48:35–42, 1973

    PubMed  Google Scholar 

  13. Saunders DR, Sillery J, McDonald GB: Regional differences in oxalate absorption by rat intestine: Evidence for excessive absorption by the colon in steatorrhea. Gut 16:543–548, 1975

    PubMed  Google Scholar 

  14. Chadwick VS, Modha K, Dowling RH: Hyperoxaluria with ileal dysfunction (letter to the editor). N Engl J Med 290:108, 1974

    PubMed  Google Scholar 

  15. Binder HJ: Intestinal oxalate absorption. Gastroenterology 67:441–446, 1974

    PubMed  Google Scholar 

  16. Chadwick VS, Elias E, Bell GD, Dowling DH: The role of bile acids in the increased intestinal absorption of oxalate after ileal resection. Advances in Bile Acid Research. S. Matern, J Hackenschmidt, P. Back, W. Gerek (eds). Stuttgart, EK Schattauer Verlag, 1975, pp 435–438

    Google Scholar 

  17. Dobbins JW, Binder HJ: Effect of bile salts and fatty aicds on the colonic absorption of oxalate. Gastroenterology 70:1096–1100, 1976

    PubMed  Google Scholar 

  18. Addersson H, Jagenburg R: Fat-reduced diet in the treatment of hyperoxaluria in patients with ileopathy. Gut 15:360–366, 1974

    Google Scholar 

  19. Stauffer JQ, Stewart RJ, Bertrand G: Acquired hyperoxaluria: Relationship to dietary calcium content and severity of steatorrhea. Gastroenterology 66:783, 1974 (abstract)

    Google Scholar 

  20. Earnest DL, Williams, HE, Admirand WH: Treatment of enteric hyperoxaluria with calcium and medium chain triglyceride. Clin Res 23:130, 1975 (abstract)

    Google Scholar 

  21. Zarembski PM, Hodgkinson A: The oxalic acid content of English diets. Br J Nutr 16:627–634, 1962

    PubMed  Google Scholar 

  22. Hodgkinson A, Williams A: An improved colorimetric procedure for urinary oxalate. Clin Chim Acta 36:127–132, 1972

    PubMed  Google Scholar 

  23. Hawk PB, Oser BL, Summerson WH (eds): Practical Physiological Chemistry, 12th ed. New York, Blakiston, 1954, p 506

    Google Scholar 

  24. Van de Kamer JH, ten Bokkell Hurnkik, and Weijers HA: Rapid method for the determination of fat in feces. J Biol Chem 177:347–355, 1949

    Google Scholar 

  25. McDonald GB, Earnest DL, Admirand WH: Hyperoxaluria correlates with steatorrhea in patients with celiac sprue. Gastroenterology 68:A92/949, 1975 (abstract)

    Google Scholar 

  26. Melnick I, Landes RR, Hoffmann AA, Burch JF: Magnesium therapy for recurring calcium oxalate urinary calculi. J Urol 105:119, 1971

    PubMed  Google Scholar 

  27. Hofmann AF Poley JR: Cholestyramine treatment of diarrhea associated with ileal resection. N Engl J Med 281:397–402, 1969

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Upstate Medical Center, 13210, Syracuse, New York

    John Q. Stauffer MD

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  1. John Q. Stauffer MD
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Stauffer, J.Q. Hyperoxaluria and intestinal disease. Digest Dis Sci 22, 921–928 (1977). https://doi.org/10.1007/BF01076170

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  • DOI: https://doi.org/10.1007/BF01076170

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