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[Iatrogenic oxalic lithiasis caused by pyridoxilate]
Nephrologie
|January 1, 1985
Summary
Piridoxilate, a drug for angina, can cause hyperoxaluria and kidney stones. Stopping the medication significantly reduced oxalate levels in patients and volunteers, indicating it
Area of Science:
- Nephrology
- Pharmacology
- Biochemistry
Context:
- Piridoxilate is prescribed for cardiovascular conditions like angina pectoris and arteritis.
- It is chemically described as an intramolecular association of glyoxylic hemiacetal salts of pyridoxine.
- Glyoxylate is believed to offer membranous protection, while pyridoxine theoretically prevents glyoxylic acid oxidation to oxalic acid.
Purpose:
- To investigate the potential link between Piridoxilate use and calcium oxalate lithiasis.
- To assess the effect of Piridoxilate on urinary oxalate levels in patients and healthy volunteers.
- To determine if Piridoxilate can induce experimental urolithiasis.
Summary:
- Piridoxilate (P) administration was associated with hyperoxaluria in 12 patients with active calcium oxalate lithiasis.
- Discontinuation of Piridoxilate led to a significant decrease in hyperoxaluria in these patients.
- Both oral and intravenous administration of Piridoxilate induced significant hyperoxaluria in volunteers.
- Experimental studies in Wistar rats demonstrated that Piridoxilate administration resulted in the formation of calcium oxalate urinary stones.
Impact:
- Piridoxilate is identified as a significant lithogenic factor, contributing to the formation of calcium oxalate stones.
- This finding suggests a need to reconsider the use of Piridoxilate in patients predisposed to or suffering from oxalate urolithiasis.
- The study highlights a potential adverse effect of Piridoxilate, necessitating further research into its metabolic pathways and clinical implications.