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

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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.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatric and Adolescent Medicine, University Hospital Cologne, Kerpenerstrasse 62, 50924, Cologne, Germany

    Renate Hueppelshaeuser, Sandra Habbig & Bernd Hoppe

  2. Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany

    Gerd E. von Unruh

  3. Institute of Human Genetics, University Hospital Cologne, Kerpenerstrasse 62, 50924, Cologne, Germany

    Bodo B. Beck

  4. Division of Experimental Urology, Department of Urology, University Hospital Bonn, Bonn, Germany

    Albrecht Hesse

  5. Department of Pediatrics, Marien-Hospital Bonn, Bonn, Germany

    Stephan Buderus

Authors
  1. Renate Hueppelshaeuser
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  2. Gerd E. von Unruh
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  3. Sandra Habbig
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  4. Bodo B. Beck
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  5. Stephan Buderus
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  6. Albrecht Hesse
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  7. Bernd Hoppe
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Correspondence to Bernd Hoppe.

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Hueppelshaeuser, R., von Unruh, G.E., Habbig, S. et al. Enteric hyperoxaluria, recurrent urolithiasis, and systemic oxalosis in patients with Crohn’s disease. Pediatr Nephrol 27, 1103–1109 (2012). https://doi.org/10.1007/s00467-012-2126-8

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  • DOI: https://doi.org/10.1007/s00467-012-2126-8

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