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Pathophysiology and management of enteric hyperoxaluria
Jordan Desenclos1, Valentine Forté1, Cécile Clément1
1Explorations Fonctionnelles Multidisciplinaires, AP-HP, Hôpital Tenon, 4 rue de la Chine, Paris F-75020, France.
Clinics and Research in Hepatology and Gastroenterology
|March 19, 2024
Summary
Enteric hyperoxaluria, a condition of excess gut oxalate absorption, increases kidney stone risk. Early diagnosis and management are crucial for patients with bowel diseases and after bariatric surgery to prevent kidney damage.
Area of Science:
- Nephrology
- Gastroenterology
- Metabolic Disorders
Background:
- Enteric hyperoxaluria (EH) is a metabolic disorder characterized by increased urinary oxalate excretion.
- It stems from conditions causing fatty acid malabsorption, leading to excessive oxalate absorption in the gut.
- EH is linked to kidney stones, crystalline nephropathies, and potential silent kidney function damage, particularly in patients with bowel diseases.
Purpose of the Study:
- To highlight the underdiagnosis of enteric hyperoxaluria.
- To discuss the increasing prevalence due to bariatric surgery.
- To review current therapeutic strategies and identify the need for novel treatments.
Main Methods:
- Literature review of metabolic disorders and kidney stone formation.
- Analysis of the pathophysiology of enteric hyperoxaluria.
- Examination of current treatment modalities and their limitations.
Main Results:
- Enteric hyperoxaluria leads to hyperoxaluria and subsequent calcium oxalate crystal formation in the kidneys.
- Bariatric surgery is a significant contributing factor to the rising incidence of EH.
- Current treatments include managing underlying conditions, dietary modifications, and increasing fluid/citrate intake.
Conclusions:
- Enteric hyperoxaluria is likely underdiagnosed and poses a risk to kidney function, especially in patients with gastrointestinal issues.
- There is a critical need for further research into the natural history of kidney disease in EH patients.
- Development of new therapies to prevent kidney injury from calcium oxalate crystallization is essential.
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