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

• Published in: Pediatric nephrology (Berlin, West) West), 2012-07, Vol.27 (7), p.1103-1109
• Main Authors: Hueppelshaeuser, Renate, von Unruh, Gerd E., Habbig, Sandra, Beck, Bodo B., Buderus, Stephan, Hesse, Albrecht, Hoppe, Bernd
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Bowel disease; Calcium Oxalate - metabolism; Calculi, Urinary; Care and treatment; Child; Crohn Disease - complications; Crohn Disease - metabolism; Crohn's disease; Female; Hospitals; Humans; Hyperoxaluria - etiology; Hyperoxaluria - metabolism; Kidney stones; Male; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Nephrology; Original Article; Oxalates; Oxalic acid; Pediatrics; Risk factors; Urinary tract diseases; Urolithiasis - etiology; Urolithiasis - metabolism; Urology; Young Adult
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-012-2126-8

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 [ 13 C 2 ]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 m 2 /24 h, p