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Hyperoxaluria in kidney stone formers treated with modern bariatric surgery.
J Urol 2007; 177(2):565-9JU

Abstract

PURPOSE

Nephrolithiasis and renal failure secondary to severe hyperoxaluria were complications of jejunoileal bypass for obesity, leading to the discontinuation of this procedure in the United States in 1980. Bariatric procedures currently in use have not been adequately evaluated for this complication.

MATERIALS AND METHODS

We compared 24-hour urine chemistry studies of 132 patients with nephrolithiasis who had undergone bariatric surgery with the urine chemistry studies of patients who had undergone jejunoileal bypass, those with routine kidney stones and normal subjects. The primary aim was to determine if hyperoxaluria developed in patients who underwent bariatric surgery and had kidney stones as had been seen with jejunoileal bypass.

RESULTS

Patients who have undergone modern bariatric surgery had an adjusted mean urine oxalate excretion of 83 mg per day compared to 39 mg per day for routine kidney stone formers and 34 mg per day for normal subjects (p <0.001 for both comparisons), but not quite as high as that found in patients treated with jejunoileal bypass (102 mg per day, p <0.001). Urine supersaturation of calcium oxalate, the main driving force for calcium oxalate stone formation, was higher in patients treated with bariatric surgery compared to routine kidney stone formers and normal subjects (p <0.001 for both comparisons).

CONCLUSIONS

Hyperoxaluria is the most significant abnormality of urine chemistry studies in patients with kidney stones who have undergone bariatric surgery. Many of these patients have a degree of hyperoxaluria that could lead to kidney failure. Further studies are required to determine the prevalence of this problem in patients who have undergone bariatric surgery.

Authors+Show Affiliations

Litholink Corporation and the Section of Nephrology, University of Chicago, Chicago, Illinois, USA. jasplin@litholink.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17222634

Citation

Asplin, John R., and Fredric L. Coe. "Hyperoxaluria in Kidney Stone Formers Treated With Modern Bariatric Surgery." The Journal of Urology, vol. 177, no. 2, 2007, pp. 565-9.
Asplin JR, Coe FL. Hyperoxaluria in kidney stone formers treated with modern bariatric surgery. J Urol. 2007;177(2):565-9.
Asplin, J. R., & Coe, F. L. (2007). Hyperoxaluria in kidney stone formers treated with modern bariatric surgery. The Journal of Urology, 177(2), pp. 565-9.
Asplin JR, Coe FL. Hyperoxaluria in Kidney Stone Formers Treated With Modern Bariatric Surgery. J Urol. 2007;177(2):565-9. PubMed PMID: 17222634.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperoxaluria in kidney stone formers treated with modern bariatric surgery. AU - Asplin,John R, AU - Coe,Fredric L, PY - 2006/02/22/received PY - 2007/1/16/pubmed PY - 2007/2/28/medline PY - 2007/1/16/entrez SP - 565 EP - 9 JF - The Journal of urology JO - J. Urol. VL - 177 IS - 2 N2 - PURPOSE: Nephrolithiasis and renal failure secondary to severe hyperoxaluria were complications of jejunoileal bypass for obesity, leading to the discontinuation of this procedure in the United States in 1980. Bariatric procedures currently in use have not been adequately evaluated for this complication. MATERIALS AND METHODS: We compared 24-hour urine chemistry studies of 132 patients with nephrolithiasis who had undergone bariatric surgery with the urine chemistry studies of patients who had undergone jejunoileal bypass, those with routine kidney stones and normal subjects. The primary aim was to determine if hyperoxaluria developed in patients who underwent bariatric surgery and had kidney stones as had been seen with jejunoileal bypass. RESULTS: Patients who have undergone modern bariatric surgery had an adjusted mean urine oxalate excretion of 83 mg per day compared to 39 mg per day for routine kidney stone formers and 34 mg per day for normal subjects (p <0.001 for both comparisons), but not quite as high as that found in patients treated with jejunoileal bypass (102 mg per day, p <0.001). Urine supersaturation of calcium oxalate, the main driving force for calcium oxalate stone formation, was higher in patients treated with bariatric surgery compared to routine kidney stone formers and normal subjects (p <0.001 for both comparisons). CONCLUSIONS: Hyperoxaluria is the most significant abnormality of urine chemistry studies in patients with kidney stones who have undergone bariatric surgery. Many of these patients have a degree of hyperoxaluria that could lead to kidney failure. Further studies are required to determine the prevalence of this problem in patients who have undergone bariatric surgery. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/17222634/full_citation L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2006.09.033?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -