Natalia Stepanova1, Lesya Korol2, Larysa Lebid2, Lyudmyla Snisar2, Svitlana Savchenko2. 1. State Institution 'Institute of Nephrology of the National Academy of Medical Sciences', Kyiv, Ukraine nmstep88@gmail.com. 2. State Institution 'Institute of Nephrology of the National Academy of Medical Sciences', Kyiv, Ukraine.
Abstract
BACKGROUND: Little evidence is available on oxalate balance in peritoneal dialysis (PD) patients. PATIENTS AND METHODS: We performed a cross-sectional observational pilot study with 62 adult PD patients to document oxalate balance and explore its association with PD-related peritonitis. Plasma oxalate concentration, levels of oxalate excretion in 24-h urine, and peritoneal dialysis effluent were evaluated. The peritoneal oxalate transport status and renal and peritoneal oxalate clearances were calculated according to the PD-related peritonitis history. RESULTS: PD patients with a history of peritonitis had a statistically significantly lower peritoneal oxalate clearance, daily peritoneal oxalate excretion, and overall oxalate removal rate compared with the peritonitis-free PD patients. They had a 4-fold risk of plasma oxalic acid increase, and even a single episode of dialysis-related peritonitis resulted in plasma oxalate elevation. CONCLUSION: Peritoneal oxalate clearance plays an important role in oxalate balance in PD patients and, therefore, dialysis-related peritonitis is a significant predictor for hyperoxalemia. Further well-designed clinical trials need to be undertaken before the association between peritonitis and oxalate balance in PD patients is more clearly understood. Copyright
BACKGROUND: Little evidence is available on oxalate balance in peritoneal dialysis (PD) patients. PATIENTS AND METHODS: We performed a cross-sectional observational pilot study with 62 adult PD patients to document oxalate balance and explore its association with PD-related peritonitis. Plasma oxalate concentration, levels of oxalate excretion in 24-h urine, and peritoneal dialysis effluent were evaluated. The peritoneal oxalate transport status and renal and peritoneal oxalate clearances were calculated according to the PD-related peritonitis history. RESULTS: PD patients with a history of peritonitis had a statistically significantly lower peritoneal oxalate clearance, daily peritoneal oxalate excretion, and overall oxalate removal rate compared with the peritonitis-free PD patients. They had a 4-fold risk of plasma oxalic acid increase, and even a single episode of dialysis-related peritonitis resulted in plasma oxalate elevation. CONCLUSION: Peritoneal oxalate clearance plays an important role in oxalate balance in PD patients and, therefore, dialysis-related peritonitis is a significant predictor for hyperoxalemia. Further well-designed clinical trials need to be undertaken before the association between peritonitis and oxalate balance in PD patients is more clearly understood. Copyright
Authors: Viktoria Kharlamb; Jennifer Schelker; Fritz Francois; Juquan Jiang; Ross P Holmes; David S Goldfarb Journal: J Endourol Date: 2011-10-21 Impact factor: 2.942
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