Article
Urinary oxalate excretion in urolithiasis and nephrocalcinosis
Thomas J Neuhausa, Tanja Belzera, Nenad Blaub, Bernd Hoppea, Harmeet Sidhuc, Ernst Leumanna
a Nephrology Unit,
University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zurich,
Switzerland, b Division of Clinical Chemistry
and Biochemistry, University Children's Hospital, c Division of Oxalate Research, Ixion
Biotechnology, Alachua, Florida, USA
Correspondence to: Dr Neuhaus email: Thomas.Neuhaus{at}kispi.unizh.ch
Accepted 7 January 2000
AIMS
To investigate
urinary oxalate excretion in children with urolithiasis and/or
nephrocalcinosis and to classify hyperoxaluria (HyOx).
METHODSA total of 106 patients were screened. In those in whom the oxalate: creatinine
ratio was increased, 24 hour urinary oxalate excretion was measured.
Liver biopsy and/or genomic analysis was performed if primary
hyperoxaluria (PH) was suspected. Stool specimens were examined for
Oxalobacter formigenes in HyOx
not related to PH type 1 or 2 (PH1, PH2) and in controls.
RESULTSA total of 21 patients screened had HyOx (>0.5 mmol/24 h per 1.73 m2);
they were classified into five groups. Eleven had PH (PH1 in nine and
neither PH1 nor PH2 in two). Six had secondary HyOx: two enteric and
four dietary. Four could not be classified. Seven patients had
concomitant hypercalciuria. Only one of 12 patients was colonised with
O formigenes compared to six of
13 controls.
CONCLUSIONSHyOx is an
important risk factor for urolithiasis and nephrocalcinosis in
children, and can coexist with hypercalciuria. A novel type of PH is
proposed. Absence of O
formigenes may contribute to HyOx not related to PH1.
Keywords: hyperoxaluria; nephrocalcinosis; urolithiasis; Oxalobacter formigenes
© 2000 by Archives of Disease in Childhood
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