Document Detail


Response to dietary oxalate after bariatric surgery.
MedLine Citation:
PMID:  23024163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Bariatric surgery (BS) may be associated with increased oxalate excretion and a higher risk of nephrolithiasis. This study aimed to investigate urinary abnormalities and responses to an acute oxalate load as an indirect assessment of the intestinal absorption of oxalate in this population.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Twenty-four-hour urine specimens were collected from 61 patients a median of 48 months after BS (post-BS) as well as from 30 morbidly obese (MO) participants; dietary information was obtained through 24-hour food recalls. An oral oxalate load test (OLT), consisting of 2-hour urine samples after overnight fasting and 2, 4, and 6 hours after consuming 375 mg of oxalate (spinach juice), was performed on 21 MO and 22 post-BS patients 12 months after BS. Ten post-BS patients also underwent OLT before surgery (pre-BS).
RESULTS: There was a higher percentage of low urinary volume (<1.5 L/d) in post-BS versus MO (P<0.001). Hypocitraturia and hyperoxaluria (P=0.13 and P=0.36, respectively) were more frequent in BS versus MO patients. The OLT showed intragroup (P<0.001 for all periods versus baseline) and intergroup differences (P<0.001 for post-BS versus MO; P=0.03 for post-BS versus pre-BS). The total mean increment in oxaluria after 6 hours of load, expressed as area under the curve, was higher in both post-BS versus MO and in post-BS versus pre-BS participants (P<0.001 for both).
CONCLUSIONS: The mean oxaluric response to an oxalate load is markedly elevated in post-bariatric surgery patients, suggesting that increased intestinal absorption of dietary oxalate is a predisposing mechanism for enteric hyperoxaluria.
Authors:
Leila Froeder; Carlos Haruo Arasaki; Carlos Alberto Malheiros; Alessandra Calábria Baxmann; Ita Pfeferman Heilberg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-09-27
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  7     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  2013-05-13     Revised Date:  2013-12-12    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2033-40     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Bariatric Surgery / adverse effects*
Calcium / urine
Chi-Square Distribution
Citrates / urine
Creatinine / urine
Female
Humans
Hyperoxaluria / etiology,  urine*
Intestinal Absorption
Magnesium / urine
Male
Middle Aged
Obesity, Morbid / urine*
Oxalates / administration & dosage,  pharmacokinetics,  urine*
Oxalobacter formigenes
Statistics, Nonparametric
Urea / urine
Uric Acid / urine
Urine / microbiology
Chemical
Reg. No./Substance:
0/Citrates; 0/Oxalates; 268B43MJ25/Uric Acid; 8W8T17847W/Urea; AYI8EX34EU/Creatinine; I38ZP9992A/Magnesium; SY7Q814VUP/Calcium
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