Compliance in Patients with Dietary Hyperoxaluria: A Cohort Study and Systematic Review

Overview

Journal Asian J Urol

Specialty Urology

Date 2019 May 8

PMID 31061807

Citations 2

Authors

Derek B Hennessey

Ned Kinnear

Gilbert Rice

David Curry

Siobhan Woolsey

Brian Duggan

Affiliations

Soon will be listed here.

Abstract

Objective: Hyperoxaluria leads to calcium oxalate crystal formation and subsequent urolithiasis. This study aims to analyse the effect of treatment compliance in hyperoxaluria, firstly by analysis of patients with non-primary hyperoxaluria and secondly via systematic review in patients with any hyperoxaluria.

Methods: In a retrospective cohort study, adults with non-primary hyperoxaluria managed with dietary counselling in 2013 were enrolled. Twenty-four-hour (24 h) urine collections initially and at 6 months were obtained. Compliance was assessed by self-reported dietary compliance and 24 h urinary volume >2 L. Patients were followed for 24 months. Primary outcomes were urinary oxalate and calcium 24 h load at 6 months, and urolithiasis-related procedural rates at 24 months. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compatible systematic review of compliance among hyperoxaluric patients was performed.

Results: In the cohort study, of 19 eligible patients (4 female) with median age 52 years, 10 (53%) were considered compliant. Compared with the non-compliant group, these patients had significantly increased subsequent 24 h urinary volume (2250 mL 1600 mL; = 0.008) and lower procedural rates (10% 56%; = 0.033). Subsequent 24 h urinary oxalate load was non-significantly lower in compliant patients. Systematic review regarding compliance in hyperoxaluric patients revealed five studies. Only one utilised dietary counselling or analysed compliant non-compliant patients, finding no difference. None examined the effect of compliance on procedural rates.

Conclusion: Hyperoxaluria is an important cause of recurrent urolithiasis. Increasing fluid intake and reducing dietary oxalate reduce the risk of operative intervention and remain fundamental to the treatment of hyperoxaluria.

Citing Articles

OxDc-A0: an oral gastro-tolerant oxalate decarboxylase for treating secondary hyperoxaluria.

Liu H, Li C, Liu Y, Yao Q, Li Q, Yu L Urolithiasis. 2025; 53(1):47.

PMID: 40044966 DOI: 10.1007/s00240-025-01698-0.

Impact of low-oxalate diet on hyperoxaluria among patients suffering from nephrolithiasis.

Aziz K, Noreen S, Tufail T, Ishaq I, Shah M Food Sci Nutr. 2024; 12(6):4292-4298.

PMID: 38873461 PMC: 11167185. DOI: 10.1002/fsn3.4088.

Impact of the adherence to medical treatment on the main urinary metabolic disorders in patients with kidney stones.

Manzo B, Cabrera J, Emiliani E, Sanchez H, Eisner B, Torres J Asian J Urol. 2021; 8(3):275-279.

PMID: 34401334 PMC: 8356059. DOI: 10.1016/j.ajur.2020.07.002.

References

Holmes R, Goodman H, Assimos D . Contribution of dietary oxalate to urinary oxalate excretion. Kidney Int. 2001; 59(1):270-6. DOI: 10.1046/j.1523-1755.2001.00488.x. View

Siener R, Ebert D, Hesse A . Urinary oxalate excretion in female calcium oxalate stone formers with and without a history of recurrent urinary tract infections. Urol Res. 2001; 29(4):245-8. DOI: 10.1007/s002400100198. View

Borghi L, Schianchi T, Meschi T, Guerra A, Allegri F, Maggiore U . Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med. 2002; 346(2):77-84. DOI: 10.1056/NEJMoa010369. View

von Unruh G, Voss S, Sauerbruch T, Hesse A . Reference range for gastrointestinal oxalate absorption measured with a standardized [13C2]oxalate absorption test. J Urol. 2003; 169(2):687-90. DOI: 10.1097/01.ju.0000051637.63068.92. View

Krishnamurthy M, Hruska K, Chandhoke P . The urinary response to an oral oxalate load in recurrent calcium stone formers. J Urol. 2003; 169(6):2030-3. DOI: 10.1097/01.ju.0000062527.37579.49. View

Troxel S, Sidhu H, Kaul P, Low R . Intestinal Oxalobacter formigenes colonization in calcium oxalate stone formers and its relation to urinary oxalate. J Endourol. 2003; 17(3):173-6. DOI: 10.1089/089277903321618743. View

Kwak C, Kim H, Kim E, Choi M, Kim H . Urinary oxalate levels and the enteric bacterium Oxalobacter formigenes in patients with calcium oxalate urolithiasis. Eur Urol. 2003; 44(4):475-81. DOI: 10.1016/s0302-2838(03)00318-x. View

Taylor E, Stampfer M, Curhan G . Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol. 2004; 15(12):3225-32. DOI: 10.1097/01.ASN.0000146012.44570.20. View

Massey L, Liebman M, Kynast-Gales S . Ascorbate increases human oxaluria and kidney stone risk. J Nutr. 2005; 135(7):1673-7. DOI: 10.1093/jn/135.7.1673. View

10.

Shuster J, Jenkins A, Logan C, Barnett T, Riehle R, Zackson D . Soft drink consumption and urinary stone recurrence: a randomized prevention trial. J Clin Epidemiol. 1992; 45(8):911-6. DOI: 10.1016/0895-4356(92)90074-w. View

11.

Freel R, Hatch M, Green M, Soleimani M . Ileal oxalate absorption and urinary oxalate excretion are enhanced in Slc26a6 null mice. Am J Physiol Gastrointest Liver Physiol. 2005; 290(4):G719-28. DOI: 10.1152/ajpgi.00481.2005. View

12.

Sarica K, Inal Y, Erturhan S, Yagci F . The effect of calcium channel blockers on stone regrowth and recurrence after shock wave lithotripsy. Urol Res. 2006; 34(3):184-9. DOI: 10.1007/s00240-006-0040-x. View

13.

Jiang Z, Asplin J, Evan A, Rajendran V, Velazquez H, Nottoli T . Calcium oxalate urolithiasis in mice lacking anion transporter Slc26a6. Nat Genet. 2006; 38(4):474-8. DOI: 10.1038/ng1762. View

14.

Voss S, Hesse A, Zimmermann D, Sauerbruch T, von Unruh G . Intestinal oxalate absorption is higher in idiopathic calcium oxalate stone formers than in healthy controls: measurements with the [(13)C2]oxalate absorption test. J Urol. 2006; 175(5):1711-5. DOI: 10.1016/S0022-5347(05)01001-3. View

15.

Laminski N, Meyers A, Kruger M, Sonnekus M, Margolius L . Hyperoxaluria in patients with recurrent calcium oxalate calculi: dietary and other risk factors. Br J Urol. 1991; 68(5):454-8. DOI: 10.1111/j.1464-410x.1991.tb15383.x. View

16.

Edwards P, ROSE G . Metabolism of pyridoxine in mild metabolic hyperoxaluria and primary hyperoxaluria (type 1). Urol Int. 1991; 47(3):113-7. DOI: 10.1159/000282203. View

17.

Penniston K, Nakada S . Effect of dietary changes on urinary oxalate excretion and calcium oxalate supersaturation in patients with hyperoxaluric stone formation. Urology. 2009; 73(3):484-9. DOI: 10.1016/j.urology.2008.10.035. View

18.

Nouvenne A, Meschi T, Guerra A, Allegri F, Prati B, Fiaccadori E . Diet to reduce mild hyperoxaluria in patients with idiopathic calcium oxalate stone formation: a pilot study. Urology. 2009; 73(4):725-30, 730.e1. DOI: 10.1016/j.urology.2008.11.006. View

19.

Bensalah K, Tuncel A, Raman J, Bagrodia A, Pearle M, Lotan Y . How physician and patient perceptions differ regarding medical management of stone disease. J Urol. 2009; 182(3):998-1004. DOI: 10.1016/j.juro.2009.05.025. View

20.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009; 62(10):e1-34. DOI: 10.1016/j.jclinepi.2009.06.006. View