Abstract:
BACKGROUND:Patients with primary hyperoxaluria (PH) overproduce oxalate which is eliminated via the kidneys. If end-stage kidney disease develops they are at high risk for systemic oxalosis, unless adequate oxalate is removed during hemodialysis (HD) to equal or exceed ongoing oxalate production. The purpose of this study was to validate a method to measure oxalate removal in this unique group of dialysis patients. METHODS:Fourteen stable patients with a confirmed diagnosis of PH on HD were included in the study. Oxalate was measured serially in hemodialysate and plasma samples in order to calculate rates of oxalate removal. HD regimens were adjusted according to a given patient's historical oxalate production, amount of oxalate removal at dialysis, residual renal clearance of oxalate, and plasma oxalate levels. RESULTS:After a typical session of HD, plasma oxalate was reduced by 78.4 ± 7.7%. Eight patients performed HD 6 times/week, 2 patients 5 times/week, and 3 patients 3 times/week. Combined oxalate removal by HD and the kidneys was sufficient to match or exceed endogenous oxalate production. After a median period of 9 months, pre-dialysis plasma oxalate was significantly lower than initially (75.1 ± 33.4 vs. 54.8 ± 46.6 mmol/l, p = 0.02). CONCLUSION:This methodology can be used to individualize the dialysis prescription of PH patients to prevent oxalosis during the time they are maintained on HD and to reduce risk of oxalate injury to a transplanted kidney.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Tang X,Voskoboev NV,Wannarka SL,Olson JB,Milliner DS,Lieske JCdoi
10.1159/000360624subject
Has Abstractpub_date
2014-01-01 00:00:00pages
376-82issue
5eissn
0250-8095issn
1421-9670pii
000360624journal_volume
39pub_type
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journal_title:American journal of nephrology
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abstract::Collapsing glomerulopathy is a pattern of renal injury that is seen in association with human immunodeficiency virus (HIV) infection. Patients with this HIV-associated nephropathy (HIVAN) present nephrotic syndrome and rapid deterioration of the renal function. There is no proven effective therapy for HIVAN, and the m...
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pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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