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Shabani E, Khorshidi A, Sayehmiri K, Moradi K, Nabi Abdolyousefi E. The effect of nutritional factors on urolithiasis: A case-control study. J Med Life 2023; 16:1062-1069. [PMID: 37900086 PMCID: PMC10600667 DOI: 10.25122/jml-2022-0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/27/2023] [Indexed: 10/31/2023] Open
Abstract
Urolithiasis, a prevalent chronic kidney disease affecting all age groups, can be influenced by nutritional factors. The incidence of urolithiasis in Asian countries ranges from 1% to 19.1%, attributed to geographical and lifestyle differences. In Iran, several risk factors, including ethnicity, dietary habits, gender, and age, are associated with urolithiasis. This study aimed to assess the impact of nutritional factors on kidney and urinary tract stone formation. This case-control study enrolled 127 newly diagnosed urolithiasis patients, and 127 matched healthy participants between February to May 2017. Exclusion criteria included diabetes and acute or chronic renal failure. Data were collected using the Food Frequency Questionnaire (FFQ) and analyzed using chi-square and logistic regression tests. Water (95% CI: 0.09-0.89, OR=0.28), natural juices (95% CI: 0.10-0.65, OR=0.53), mineral water (95% CI: 0.05-0.64, OR=0.18), legumes (95% CI: 0.00-0.38, OR=0.032), butter, cream, or peppermint (95% CI: 0.09-0.95, OR=0.30), and ice cream (95% CI: 0.07-0.54, OR=0.203) had a significant protective effect against kidney and urinary tract stone formation. Conversely, tea consumption (95% CI: 1.15-7.99, OR=4.70), beverages (95% CI: 4.45-23.32, OR=23.32), coffee (95% CI: 1.63-11.78, OR=4.39), bread (95% CI: 1.1-10.59, OR=3.37), meat (95% CI: 1.01-8.01, OR=2.85), liver (95% CI: 3.37-488.90, OR=40.58), fish (95% CI: 2.89-216.39, OR=25.03), and various canned foods (95% CI: 1.34-10.25, OR=3.70) were significantly associated with kidney and urinary tract stone risk. These findings showed that the risk of urinary stones formation had a significant relationship with dietary habits. Therefore, the correct dietary pattern and sufficient fluid consumption may play an important role in preventing urinary stones.
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Affiliation(s)
- Ehsan Shabani
- Epidemiology Student Research Committee, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Khorshidi
- School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Kourosh Sayehmiri
- Psychosocial Injuries Research Centre, Ilam University of Medical Sciences, Ilam, Iran
| | - Kamran Moradi
- Department of Urology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Ehsan Nabi Abdolyousefi
- Genetic Student Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Siener R, Hesse A. Effect of Black Tea Consumption on Urinary Risk Factors for Kidney Stone Formation. Nutrients 2021; 13:4434. [PMID: 34959987 PMCID: PMC8708000 DOI: 10.3390/nu13124434] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023] Open
Abstract
Copious fluid intake is the most essential nutritional measure in the treatment of urolithiasis, and is suggested to be a protective factor in the primary prevention of urinary stone formation. Although the intake of black tea contributes to daily fluid intake, the high oxalate content could outweigh the beneficial effect of urine dilution. The present study investigated the effect of black tea consumption on urinary risk factors for kidney stone formation. Ten healthy men received a standardized diet for a period of ten days. Subjects consumed 1.5 L/day of fruit tea (0 mg/day oxalate) during the 5-day control phase, which was replaced by 1.5 L/day of black tea (86 mg/day oxalate) during the 5-day test phase. Fractional and 24-h urines were obtained. The intake of black tea did not significantly alter 24-h urinary oxalate excretion. Urinary citrate, an important inhibitor of calcium stone formation, increased significantly, while the relative supersaturation of calcium oxalate, uric acid, and struvite remained unchanged. No significantly increased risk for kidney stone formation could be derived from the ingestion of black tea in normal subjects. Further research is needed to evaluate the impact of black tea consumption in kidney stone patients with intestinal hyperabsorption of oxalate.
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Affiliation(s)
- Roswitha Siener
- Department of Urology, University Stone Center, University Hospital Bonn, 53127 Bonn, Germany;
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Diet-related urine collections: assistance in categorization of hyperoxaluria. Urolithiasis 2021; 50:141-148. [PMID: 34821949 PMCID: PMC8956551 DOI: 10.1007/s00240-021-01290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/14/2021] [Indexed: 11/15/2022]
Abstract
Hyperoxaluria, one of the major risk factors for calcium oxalate urolithiasis and nephrocalcinosis, causes significant morbidity and mortality and should therefore be detected and treated as soon as possible. An early, consequent and adequate evaluation, but also a distinction between primary (PH) and secondary hyperoxaluria (SH) is therefore essential. We evaluated the usefulness of three consecutive 24-h urine collections under different diets [usual diet, (A), low oxalate diet, (B), high oxalate diet, (C)] to prove SH, or to find evidence of PH by changes in urinary oxalate excretion (Uox). We retrospectively analyzed results from 96 pediatric patients (47 females and 49 males, age 3–18 years) who presented with a history of nephrolithiasis, nephrocalcinosis and/or persistent hematuria in whom hyperoxaluria was found in an initial urine sample. The typical pattern of SH was found in 34 patients (mean Uox (A) 0.85 ± 0.29, (B) 0.54 ± 0.15 and (C) 0.95 ± 0.28 mmol/1.73m2/d). PH was suspected in 13 patients [(A) 1.21 ± 0.75; (B) 1.47 ± 0.51 and (C) 1.60 ± 0.82 mmol/1.73m2/d], but genetically proven only in 1/5 patients examined. No hyperoxaluria was found in 16 patients. Data were inconclusive in 33 patients. Urine collection under different diets is helpful to diagnose secondary hyperoxaluria and may provide evidence, that urinary oxalate excretion is normal. We have now established this procedure as our first diagnostic step before further, more extensive and more expensive evaluations are performed.
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Tea and coffee consumption and pathophysiology related to kidney stone formation: a systematic review. World J Urol 2020; 39:2417-2426. [PMID: 33052484 DOI: 10.1007/s00345-020-03466-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To explore the mechanisms behind the potential protective effect of coffee and tea consumption, regarding urinary stone formation, previously demonstrated in large epidemiological studies. METHODS A systematic review was performed using the Medline, Cochrane library (CENTRAL) and Scopus databases, in concordance with the PRISMA statement. English, French and Spanish language studies, regarding the consumption of caffeinated and decaffeinated coffee and tea, and the relationship to urinary stone formation were reviewed. Meta-analyses, systematic reviews, case reports and letters, unpublished studies, posters and comments abstracts were excluded. RESULTS As per the inclusion criteria, 13 studies were included in the final review. The major findings show that caffeine increases urinary excretion of calcium, sodium and magnesium, in addition to a diuretic action with consumption > 300-360 mg (approximately four cups of coffee). Together with other components of coffee, this beverage might have potential protective effects against the formation of urinary stones. Tea exerts many protective effects against stone formation, through the accompanying water intake, the action of caffeine and the effects of components with antioxidant properties. CONCLUSION Caffeine has a hypercalciuric effect, balanced partially by a diuretic effect which appears after consumption of large quantities of caffeine. The current available literature supports in general, a potentially protective role for tea against stone formation, mainly for green tea. Additional standardization in this field of research, through specification of tea and coffee types studied, and their respective compositions, is needed for further clarification of the relation between coffee, tea and urinary stones.
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Batista NN, Ramos CL, de Figueiredo Vilela L, Dias DR, Schwan RF. Fermentation of yam (Dioscorea spp. L.) by indigenous phytase-producing lactic acid bacteria strains. Braz J Microbiol 2019; 50:507-514. [PMID: 30806891 DOI: 10.1007/s42770-019-00059-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/22/2019] [Indexed: 11/28/2022] Open
Abstract
The use of lactic bacteria in the development of functional foods has increased in recent years. In addition to their probiotic characteristics, they can ferment a variety of substrates, such as cereals, roots, and tubers. Phytase producer lactic acid bacteria strains and their behavior during the fermentation process of yam-based food were studied. Leuconostoc lactis CCMA 0415, Lactobacillus plantarum CCMA 0744, and Lactobacillus fermentum CCMA 0745 were selected due to phytase production, pH reduction, and growth during 24 h of fermentation. Oxalate activity was not detected in all assays, suggesting its concentration was reduced due to the bleaching process. Among the selected strains, L. lactis CCMA 0415 appeared to be a promising strain in yam-based fermentations because it maintained a cell viability above 8 log CFU/mL and did not reduce diosgenin concentrations (around 8.0 μg/mL) after fermentation for 24 h, thereby, generating a potentially functional yam food. Furthermore, this strain promoted the decrease of pH value from 6.1 to 3.8 and produced 8.1 g/L lactic acid, at 6 h of fermentation. The L. lactis CCMA 0415 was reported as a starter culture in fermented products based on cereals, roots, and tubers.
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Affiliation(s)
- Nádia Nara Batista
- Department of Food Science, Federal University of Lavras, Lavras, MG, 37200-000, Brazil
| | - Cíntia Lacerda Ramos
- Department of Biology, Federal University of Lavras, Campus Universitário, 3037, Lavras, MG, 37200-000, Brazil.,Department of Basic Science, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, MG, 39100-000, Brazil
| | | | - Disney Ribeiro Dias
- Department of Food Science, Federal University of Lavras, Lavras, MG, 37200-000, Brazil
| | - Rosane Freitas Schwan
- Department of Biology, Federal University of Lavras, Campus Universitário, 3037, Lavras, MG, 37200-000, Brazil.
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Shu X, Cai H, Xiang Y, Li H, Lipworth L, Miller NL, Zheng W, Shu X, Hsi RS. Green tea intake and risk of incident kidney stones: Prospective cohort studies in middle‐aged and elderly Chinese individuals. Int J Urol 2018; 26:241-246. [DOI: 10.1111/iju.13849] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/15/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Xiang Shu
- Division of Epidemiology Department of Medicine Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer Center Vanderbilt University Medical Center Nashville Tennessee USA
| | - Hui Cai
- Division of Epidemiology Department of Medicine Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer Center Vanderbilt University Medical Center Nashville Tennessee USA
| | - Yong‐Bing Xiang
- State Key Laboratory of Oncogene and Related Genes Department of Epidemiology Shanghai Cancer Institute Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Honglan Li
- State Key Laboratory of Oncogene and Related Genes Department of Epidemiology Shanghai Cancer Institute Renji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Loren Lipworth
- Division of Epidemiology Department of Medicine Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer Center Vanderbilt University Medical Center Nashville Tennessee USA
- Vanderbilt O'Brien Center for Kidney Disease Vanderbilt University Medical Center Nashville Tennessee, USA
| | - Nicole L Miller
- Department of Urologic Surgery Vanderbilt University Medical Center Nashville Tennessee USA
| | - Wei Zheng
- Division of Epidemiology Department of Medicine Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer Center Vanderbilt University Medical Center Nashville Tennessee USA
| | - Xiao‐Ou Shu
- Division of Epidemiology Department of Medicine Vanderbilt Epidemiology Center Vanderbilt‐Ingram Cancer Center Vanderbilt University Medical Center Nashville Tennessee USA
| | - Ryan S Hsi
- Department of Urologic Surgery Vanderbilt University Medical Center Nashville Tennessee USA
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Chen K, Chen D, Lan C, Liang X, Zeng T, Huang J, Duan X, Kong Z, Li S, Tiselius HG, Gurioli A, Lu X, Zeng G, Wu W. Does green tea consumption increase urinary oxalate excretion? Results of a prospective trial in healthy men. Int Urol Nephrol 2017; 50:29-33. [PMID: 29052087 DOI: 10.1007/s11255-017-1720-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/06/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate the impact of green tea on urinary oxalate excretion in healthy male volunteers. MATERIALS AND METHODS The oxalate concentrations after different brewing times (2-60 min) of different qualities (2-8 g) of green tea were measured in in vitro experiment. In in vivo experiment, the effects on urine composition were assessed in 12 healthy men with an age of 24-29 years. Each subject was requested to collect two 24-h urine samples under normal dietary conditions. Green tea prepared from tea bags containing 2 g of tea leafs was consumed by the subjects for 7 consecutive days, and 24-h urine samples were collected and analyzed on days 6 and 7. After 3-week washout interval, all subjects consumed green tea containing 4 g of leaf tea for another 7 consecutive days. Two 24-h urine samples were collected on the last 2 days. Urine volume, pH, calcium, magnesium, sodium, phosphate, potassium, chloride, citrate, oxalate, urate and creatinine were measured. RESULTS In the in vitro experiments, oxalate in solution increased with brewing time (p < 0.05) and tea quality (p < 0.05). In the in vivo experiment, 24-h urinary oxalate increased significantly (0.24 ± 0.09 mmol to 0.32 ± 0.13 mmol, p = 0.045) when tea was prepared from 2-g bags of green leaf tea. Consumption of green tea containing 4 g of leaf tea resulted in 24-h urinary oxalate increase (0.25 ± 0.25 mmol to 0.34 ± 0.22 mmol, p = 0.041). CONCLUSIONS In vitro studies showed that there was a gradual increase in solution concentrations of oxalate that was associated with increased brewing time and increased quality of green tea. Studies in normal men showed that green tea consumption was associated with increased urinary exertion of oxalate.
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Affiliation(s)
- Kang Chen
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Dong Chen
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Chuangxin Lan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Xiongfa Liang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Tao Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Jian Huang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Xiaolu Duan
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Zhenzhen Kong
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Shujue Li
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Hans-Göran Tiselius
- Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Alberto Gurioli
- Department of Urology, Turin University of Studies, Turin, Italy
| | - Xiaogang Lu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangdong Key Laboratory of Urology, Kangda Road 1#, Haizhu District, Guangzhou, 510230, Guangdong, China.
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Vasanthi AHR, Muthulakshmi V, Gayathri V, Manikandan R, Ananthi S, Kuruvilla S. Antiurolithiatic Effect of Sirupeelai Samoola Kudineer: A Polyherbal Siddha Decoction on Ethylene Glycol-induced Renal Calculus in Experimental Rats. Pharmacogn Mag 2017; 13:S273-S279. [PMID: 28808392 PMCID: PMC5538166 DOI: 10.4103/pm.pm_454_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/23/2016] [Indexed: 11/15/2022] Open
Abstract
Background: Sirupeelai Samoola Kudineer (SK), a polyherbal decoction containing four medicinal plants has been used in Siddha system of medicine, practiced in Southern parts of India for the management of urolithiasis. Objective: The present study is carried out to scientifically validate the traditional claim and to study the mechanism of action of the drug. Materials and Methods: In the present study, anti-urolithiatic effect of SK was evaluated in Sprague-Dawley rats using ethylene glycol through drinking water and intraperitoneal injection of sodium oxalate. Renal damage was confirmed by the increased production of thiobarbituric acid reactive substance (TBARS). Results: Co-treatment with SK to urolithiatic rats for 21 days significantly prevented the elevation of renal and urinary stone biomarkers in plasma and renal tissue thereby preventing renal damage and the formation of renal calculi. Administration of SK at all doses and cystone restored the antioxidant (glutathione) levels by preventing the elevation of TBARS in the kidney tissue, which was further confirmed by histological sections. Conclusions: SK treatment promotes diuresis which leads to flushing of the renal stones and maintains the alkaline environment in the urinary system which probably mediates the antilithiatic activity. SK provides structural and functional protection to the kidneys by enhancing its physiological function against stone formation and validates its clinical use. SUMMARY
SK exhibited antilithiatic and diuretic potential in ethylene glycol and sodium oxalate induced urolithiasis in rats Elevated urinary stone markers (Calcium, oxalate, uric acid, magnesium and phosphates) in plasma and renal tubular enzymes (LDH, GGT, ALP, AST ALT) in urolithiatic rats were reversed by SK treatment SK administration significantly reduced the level of renal stress markers like Urea, Creatinine, LPO and elevated SOD, GPx, GSH levels aiding in nephroprotection SK also provides structural and functional protection against ethylene glycol- induced renal calculus in rats as evidenced by histopathological studies. Abbreviations used: SK: Sirupeelai Samoola Kudineer; TBARS: ThioBarbituric Acid Reactive Substances; SOD: SuperOxide Dismutase; GPx: Gluthathione peroxidase; GSH- Glutathione; LPO: Lipid peroxidation as measured as TBARS; AST: Aspartate AminoTransferase; ALT: Alanine Amino transferase; GGT: Gamma Glutamyl Transferase; LDH: Lactate Dehydrogenase.
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Affiliation(s)
- A Hannah Rachel Vasanthi
- Department of Biochemistry, Herbal and Indian Medicine Research Laboratory, Chennai, Tamil Nadu, India
| | - V Muthulakshmi
- Department of Biochemistry, Herbal and Indian Medicine Research Laboratory, Chennai, Tamil Nadu, India
| | - V Gayathri
- Department of Biochemistry, Herbal and Indian Medicine Research Laboratory, Chennai, Tamil Nadu, India
| | - R Manikandan
- Department of Biochemistry, Herbal and Indian Medicine Research Laboratory, Chennai, Tamil Nadu, India
| | - S Ananthi
- Department of Biochemistry, Herbal and Indian Medicine Research Laboratory, Chennai, Tamil Nadu, India
| | - Sarah Kuruvilla
- Department of Pathology, Sri Ramachandra University, Chennai, Tamil Nadu, India
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Ramos CL, Schwan RF. Technological and nutritional aspects of indigenous Latin America fermented foods. Curr Opin Food Sci 2017. [DOI: 10.1016/j.cofs.2017.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
Oxalic acid and its salts occur as end products of metabolism in a number of plant tissues. When these plants are eaten they may have an adverse effect because oxalates bind calcium and other minerals. While oxalic acid is a normal end product of mammalian metabolism, the consumption of additional oxalic acid may cause stone formation in the urinary tract when the acid is excreted in the urine. Soaking and cooking of foodstuffs high in oxalate will reduce the oxalate content by leaching. The mean daily intake of oxalate in English diets has been calculated to be 70-150 mg, with tea appearing to contribute the greatest proportion of oxalate in these diets; rhubarb, spinach and beet are other common high oxalate-content foods. Vegetarians who consume greater amounts of vegetables will have a higher intake of oxalates, which may reduce calcium availability. This may be an increased risk factor for women, who require greater amounts of calcium in the diet. In humans, diets low in calcium and high in oxalates are not recommended but the occasional consumption of high oxalate foods as part of a nuritious diet does not pose any particular problem.
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Affiliation(s)
- S C Noonan
- Food Group, Division of Animal and Food Sciences, Lincoln University, Canterbury, New Zealand
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Chakraborty N, Ghosh R, Ghosh S, Narula K, Tayal R, Datta A, Chakraborty S. Reduction of oxalate levels in tomato fruit and consequent metabolic remodeling following overexpression of a fungal oxalate decarboxylase. PLANT PHYSIOLOGY 2013; 162:364-378. [PMID: 23482874 PMCID: PMC3641215 DOI: 10.1104/pp.112.209197] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 03/09/2013] [Indexed: 05/29/2023]
Abstract
The plant metabolite oxalic acid is increasingly recognized as a food toxin with negative effects on human nutrition. Decarboxylative degradation of oxalic acid is catalyzed, in a substrate-specific reaction, by oxalate decarboxylase (OXDC), forming formic acid and carbon dioxide. Attempts to date to reduce oxalic acid levels and to understand the biological significance of OXDC in crop plants have met with little success. To investigate the role of OXDC and the metabolic consequences of oxalate down-regulation in a heterotrophic, oxalic acid-accumulating fruit, we generated transgenic tomato (Solanum lycopersicum) plants expressing an OXDC (FvOXDC) from the fungus Flammulina velutipes specifically in the fruit. These E8.2-OXDC fruit showed up to a 90% reduction in oxalate content, which correlated with concomitant increases in calcium, iron, and citrate. Expression of OXDC affected neither carbon dioxide assimilation rates nor resulted in any detectable morphological differences in the transgenic plants. Comparative proteomic analysis suggested that metabolic remodeling was associated with the decrease in oxalate content in transgenic fruit. Examination of the E8.2-OXDC fruit proteome revealed that OXDC-responsive proteins involved in metabolism and stress responses represented the most substantially up- and down-regulated categories, respectively, in the transgenic fruit, compared with those of wild-type plants. Collectively, our study provides insights into OXDC-regulated metabolic networks and may provide a widely applicable strategy for enhancing crop nutritional value.
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Theka T, Rodgers A, Ravenscroft N, Lewandowski S. Intestinal permeability in subjects from two different race groups with diverse stone-risk profiles. Urolithiasis 2013; 41:111-7. [PMID: 23503872 DOI: 10.1007/s00240-013-0543-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Accepted: 01/04/2013] [Indexed: 12/12/2022]
Abstract
It is well established that calcium oxalate stones may be caused by colonic or ileum oxalate (Ox) hyperabsorption (secondary to intestinal dysfunction). Studies have reported that increased intestinal permeability (IP) can cause hyperabsorption of nutrients culminating in passive diffusion of Ox. In South Africa, renal stones occur in the white population (W) but are extremely rare in the black population (B). Previous studies have shown that despite B having a hyperoxalurogenic diet relative to W, urinary Ox in the former is not higher. It has been suggested that different Ox handling mechanisms in the groups are the cause of this disparity. The present study was undertaken to examine whether the IP index, a reliable and accurate measure of intestinal integrity, plays a role in this anomaly. Ten healthy males from each group ingested a dual-sugar isotonic solution containing 5 g lactulose (LA) and 2 g mannitol (MA). IP was assessed by comparing the LA:MA ratio in 5 h urine samples using high performance anion exchange chromatography coupled with pulse amperometric detection to measure the concentration of each sugar. 24 h dietary intake and urine composition were also determined. LA excretion was identical in both groups (0.03 %) while MA excretion was 8.3 % in B and 11.3 % in W. IP index was 0.004 for B and 0.003 for W. It is concluded that IP is not a contributory factor in the apparent different handling of dietary Ox in B and W South Africans. It is speculated that differences in renal transporters may play a role.
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Affiliation(s)
- Takalani Theka
- Department of Chemistry, University of Cape Town, Rondebosch, 7700, South Africa
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Schroder T, Vanhanen L, Savage GP. Oxalate content in commercially produced cocoa and dark chocolate. J Food Compost Anal 2011. [DOI: 10.1016/j.jfca.2011.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Savage G, Mårtensson L. Comparison of the estimates of the oxalate content of taro leaves and corms and a selection of Indian vegetables following hot water, hot acid and in vitro extraction methods. J Food Compost Anal 2010. [DOI: 10.1016/j.jfca.2009.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Savage G, Mårtensson L, Sedcole J. Composition of oxalates in baked taro (Colocasia esculenta var. Schott) leaves cooked alone or with additions of cows milk or coconut milk. J Food Compost Anal 2009. [DOI: 10.1016/j.jfca.2008.05.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mårtensson L, Savage GP. Composition and bioavailability of oxalates in baked taro (Colocasia esculentavar. Schott) leaves eaten with cows milk and cows milk and coconut milk. Int J Food Sci Technol 2008. [DOI: 10.1111/j.1365-2621.2008.01855.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
D-lactic acidosis, also referred to as D-lactate encephalopathy, is a rare neurologic syndrome that occurs in individuals with short bowel syndrome or following jejuno-ileal bypass surgery. Symptoms typically present after the ingestion of high-carbohydrate feedings. Neurologic symptoms include altered mental status, slurred speech, and ataxia, with patients often appearing drunk. Onset of neurologic symptoms is accompanied by metabolic acidosis and elevation of plasma D-lactate concentration. In these patients, malabsorbed carbohydrate is fermented by an abnormal bacterial flora in the colon, which produces excessive amounts of D-lactate. High amounts of D-lactate are absorbed into the circulation, resulting in an elevated concentration of D-lactate in the blood. Development of neurologic symptoms has been attributed to D-lactate, but it is unclear if this is the cause or whether other factors are responsible. This review examines the pathophysiology of the production and accumulation of D-lactate while exploring the potential factors contributing to the development of neurologic manifestations. Methods of diagnosis and treatment are reviewed. Areas requiring further investigation are identified.
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Affiliation(s)
- Craig Petersen
- University of California, Davis, Medical Center, Sacramento, CA 95817, USA.
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Horner HT, Cervantes-Martinez T, Healy R, Reddy MB, Deardorff BL, Bailey TB, Al-Wahsh I, Massey LK, Palmer RG. Oxalate and phytate concentrations in seeds of soybean cultivars [Glycine max (L.) Merr.]. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2005; 53:7870-7. [PMID: 16190644 DOI: 10.1021/jf051193i] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study analyzed soybean seeds from 116 cultivars for total, insoluble, and soluble oxalate (Ox), phytate (InsP6), calcium (Ca), and magnesium (Mg) because of their potential beneficial or harmful effects on human nutrition. These cultivars were divided into four groups (A-D) on the basis of the year and geographic location where they were grown. Oxalate concentration ranged from about 82 to 285 mg/100 g of dry seed. The InsP6 concentration ranged from 0.22 to 2.22 g/100 g of dry seed. There was no correlation between Ox and InsP6 within or among the four groups of cultivars. There was a significant correlation between total Ox and Ca, but not Mg, in group D cultivars (r = 0.3705; p < 0.0005). No significant relationship was found in the group A-C cultivars. Eleven group D cultivars had InsP6 less than 500 mg/100 g, but all had total Ox of 130 mg/100 g or greater. Five cultivars from groups A-C had relatively low InsP6 (group B; < or =1.01 g/100 g) and low Ox (<140 mg/100 g). These cultivars could be useful for producing soy foods beneficial to populations at risk for kidney stones and for improved mineral bioavailability. The Ox and InsP6 concentrations of the cultivars indicate that choosing specific parents could generate seeds in succeeding generations with desirable Ox and InsP6 concentrations.
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Affiliation(s)
- Harry T Horner
- Department of Genetics, Development and Cell Biology and Bessey Microscopy Facility, Iowa State University, Ames, Iowa 50011-1020, USA.
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Lewandowski S, Rodgers AL. Idiopathic calcium oxalate urolithiasis: risk factors and conservative treatment. Clin Chim Acta 2004; 345:17-34. [PMID: 15193974 DOI: 10.1016/j.cccn.2004.03.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2003] [Revised: 03/12/2004] [Accepted: 03/12/2004] [Indexed: 02/03/2023]
Abstract
Idiopathic calcium oxalate urolithiasis is a frequent and recurrent multifactorial disease. This review focuses on urinary and dietary risk factors for this disease and conservative strategies for rectifying them. Dietary oxalate and calcium and their respective urinary excretions have been extensively investigated during the last 10 years. Urinary oxalate has emerged as the most important determinant of calcium oxalate crystallization while the role of urinary calcium has shifted to bone balance and osteoporosis. Dietary calcium restriction increases urinary oxalate and contributes to a negative bone balance. It has therefore been abandoned as a means to reduce the risk of calcium oxalate kidney stone formation. Calcium oxalate kidney stone patients are advised to increase their fluid intake to achieve a urine volume of 2 l or more; the recommended calcium intake is 800-1200 mg/day; high oxalate foods should be restricted; daily protein intake should be between 0.8 and 1 g/kg body weight/day; essential fats should be included; vegetable and fruit (except oxalate-rich vegetables) intake should be increased. The use of calcium supplements has potential benefits but needs to be examined further.
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Affiliation(s)
- Sonja Lewandowski
- Department of Chemistry, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7701, South Africa
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Abstract
Abnormal liver function tests in patients with intestinal failure (IF) may be due to the underlying disease, IF or the treatments given (including parenteral nutrition (PN)). PN-related liver disease in children usually relates to intrahepatic cholestasis and in adults to steatosis. Steatosis may be consequent upon an excess of carbohydrate, lipid or protein, or upon a deficiency of a specific molecule. Pigment-type gallstones are common in adults and children with IF; these develop from biliary sludge that forms during periods of gallbladder stasis. Ileal disease/resection, parenteral nutrition, surgery, rapid weight loss and drugs all increase the risk of developing gallstones. Gallstone formation may be prevented by reducing gallbladder stasis (oral/enteral feeding or prokinetic agents), altering bile composition, or by means of a prophylactic cholecystectomy. Calcium oxalate renal stones are common in patients with a short bowel and retained functioning colon and are consequent upon increased absorption of dietary oxalate; they are prevented by a low-oxalate diet. An osteopathy may occur with long-term parenteral nutrition.
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Charrier MJS, Savage GP, Vanhanen L. Oxalate content and calcium binding capacity of tea and herbal teas. Asia Pac J Clin Nutr 2003; 11:298-301. [PMID: 12495262 DOI: 10.1046/j.1440-6047.2002.00294.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Thirty-two commercially available teas consisting of green, oolong and black teas were bought from supermarkets in Christchurch, New Zealand in June 2001. Fifteen herbal teas were also purchased at the same time. The soluble oxalate content of the infusate made from each of the teas was determined using high pressure liquid chromatography. The mean soluble oxalate contents of black tea in tea bags and loose tea leaves were 4.68 and 5.11 mg/g tea, respectively, while green teas and oolong tea had lower oxalate contents, ranging from 0.23 to 1.15 mg/g tea. The soluble oxalate content of the herbal teas ranged from not detected to 3.00 mg/g tea. A regular tea drinker consuming six cups of tea/day would have an intake of between 26.46 and 98.58 mg soluble oxalate/day from loose black tea, 17.88 and 93.66 mg soluble oxalate/day from black tea in tea bags and a maximum of 18.0 mg/day from herbal teas. The oxalate intake from the regular daily consumption of black teas is modest when compared to the amounts of soluble oxalate that can be found in common foods. However, oxalate in black teas has the potential to bind to a significant proportion of calcium in the milk, which is commonly consumed with the black teas.
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Affiliation(s)
- Marina J S Charrier
- Institute of Science and Engineering Techniques, University of Angers, Angers, France
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Savage GP, Charrier MJS, Vanhanen L. Bioavailability of soluble oxalate from tea and the effect of consuming milk with the tea. Eur J Clin Nutr 2003; 57:415-9. [PMID: 12627177 DOI: 10.1038/sj.ejcn.1601572] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2002] [Revised: 05/29/2002] [Accepted: 06/03/2002] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To measure the availability of oxalate normally extracted when making tea from two commercially available black teas bought from a supermarket in Christchurch, New Zealand in July 2001. DESIGN, SUBJECTS AND INTERVENTION A randomized double crossover study. Six students and four staff consumed six cups of each brand of tea both with and without added milk over a 24 h period. A total urine collection was taken for the initial 6 h followed by a further 18 h. The oxalate content of the urine voided was measured using an enzyme kit method and the availability of the soluble oxalate consumed was measured for the 6 h and the total 24 h sample. SETTING University campus. RESULTS The mean soluble oxalate content of black tea in the two different commercial tea bags was respectively 6.1 and 6.3 mg soluble oxalate/g tea. The mean availability of the oxalate extracted from tea measured over a 6 h period ranged from 1.9 to 4.7% when tea was consumed without milk. The availability of the soluble oxalate from tea ranged from -3.0 to 2.3% for each of the two brands of tea investigated over a 24 h period. CONCLUSION These studies show that consuming black tea on a daily basis will lead to a moderate intake of soluble oxalate each day, however the consumption of tea with milk on a regular basis will result in the absorption of very little oxalate from tea.
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Affiliation(s)
- G P Savage
- Food Group, AFSD, Lincoln University, Canterbury, New Zealand.
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de O G Mendonça C, Martini LA, Baxmann AC, Nishiura JL, Cuppari L, Sigulem DM, Heilberg IP. Effects of an oxalate load on urinary oxalate excretion in calcium stone formers. J Ren Nutr 2003; 13:39-46. [PMID: 12563622 DOI: 10.1053/jren.2003.50002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the oxalate intake and the effect of an oxalate load on urinary oxalate excretion in calcium stone-forming (CSF) patients. DESIGN Prospective study. SETTING University-affiliated outpatient Renal Lithiasis Unit. PATIENTS AND CONTROLS Seventy (70) CSF and 41 healthy subjects (HS) collected a 24-hour urine sample and were submitted to a 3-day dietary record to determine mean oxalate (Ox), calcium (Ca) and vitamin C intake. Fifty-eight (58) CSF patients were randomly selected to receive milk (N = 28) or dark (N = 30) chocolate as an oxalate load. INTERVENTION Administration of either milk (94 mg Ox + 430 mg Ca) or dark chocolate (94 mg Ox + 26 mg Ca) for 3 days. A 24-hour urine sample was obtained before and after the load to determine calcium, oxalate, sodium, potassium, urea, and creatinine. MAIN OUTCOME MEASURE Oxalate intake and excretion. RESULTS CSF patients presented mean Ox intake of 98 +/- 137 mg/d, similar to that of HS (108 +/- 139 mg/d). Mean Ox and vitamin C intake was directly correlated with Ox excretion only in CSF. The consumption of dark chocolate induced a significant increase in mean urinary Ox (36 +/- 14 versus 30 +/- 10 mg/24 hr) not observed in the milk chocolate group. Thus, a 2-fold increase in Ox intake in this population of CSF patients produced a significant 20% increase in oxaluria, not observed when Ca was consumed simultaneously. CONCLUSION The present study suggests that even small increases in Ox intake affect oxalate excretion and the mitigation of urinary oxalate increase by Ca consumption reinforces that Ca and Ox intakes for CSF patients should be in balance. Further studies are necessary to assess whether or not a 20% increase in oxaluria will lead to a higher risk of stone formation.
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Effects of 5 Different Diets On Urinary Risk Factors For Calcium Oxalate Kidney Stone Formation: Evidence of Different Renal Handling Mechanisms in Different Race Groups. J Urol 2002. [DOI: 10.1097/00005392-200209000-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rodgers AL, Lewandowski S. Effects of 5 different diets on urinary risk factors for calcium oxalate kidney stone formation: evidence of different renal handling mechanisms in different race groups. J Urol 2002; 168:931-6. [PMID: 12187193 DOI: 10.1016/s0022-5347(05)64545-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Since the incidence of renal calculi in the South African black population is extremely rare while in white subjects it occurs at the same rate as elsewhere in the western world, we investigated the possibility that different renal handling mechanisms in response to different dietary challenges might occur in the 2 race groups. MATERIALS AND METHODS We administered 5 different dietary protocols, including low calcium, high oxalate, vitamin C, high salt and lacto-vegetarian, to 10 healthy male subjects from each race group. We collected 24-hour urine at baseline and after 4 days on the prescribed diet which were analyzed for biochemical and physicochemical risk factors. Dietary intake was controlled throughout the experimental period. A 24-hour dietary recall questionnaire was recorded at baseline and analyzed using food composition tables. Statistical analysis of variance was performed on all the data. RESULTS The low calcium diet caused statistically significant changes only in black subjects, which consisted of urinary oxalate increase (0.17 to 0.23 mmol./24 hours, p = 0.01), relative supersaturation of calcium oxalate decrease (1.88 to 0.97, p = 0.03) and relative supersaturation of brushite increase (0.85 to 1.69, p = 0.03). The high oxalate diet caused statistically significant changes in both race groups but these changes were different in the 2 groups. In white subjects urinary pH increased (6.24 to 6.62, p = 0.01), potassium excretion increased (40.01 to 73.49, p = 0.01) and relative supersaturation of brushite increased (1.34 to 2.12, p = 0.05). In black subjects urinary citrate increased (1.94 to 2.99 mmol./24 hours, p = 0.01). Clinically unimportant changes occurred in both race groups after the other 3 diets. CONCLUSIONS Renal handling of dietary calcium and oxalate in South African black and white subjects is different and may explain the different stone incidence in the 2 race groups.
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Affiliation(s)
- Allen L Rodgers
- Department of Chemistry, University of Cape Town, South Africa
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Bushinsky DA, Asplin JR, Grynpas MD, Evan AP, Parker WR, Alexander KM, Coe FL. Calcium oxalate stone formation in genetic hypercalciuric stone-forming rats. Kidney Int 2002; 61:975-87. [PMID: 11849452 DOI: 10.1046/j.1523-1755.2002.00190.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Over 54 generations, we have successfully bred a strain of rats that maximizes urinary calcium excretion. The rats now consistently excrete 8 to 10 times as much calcium as controls, uniformly form poorly crystalline calcium phosphate kidney stones, and are termed genetic hypercalciuric stone-forming (GHS) rats. These rats were used to test the hypothesis that increasing urinary oxalate excretion would not only increase the supersaturation with respect to the calcium oxalate solid phase, but also would increase the ratio of calcium oxalate-to-calcium phosphate supersaturation and result in calcium oxalate stone formation. METHODS To increase urine oxalate excretion an oxalate precursor, hydroxyproline, was added to the diet of male GHS rats. The GHS rats were fed a standard 1.2% calcium diet alone or with 1%, 3% or 5% trans-4-hydroxy-l-proline (hydroxyproline). RESULTS The addition of 1% hydroxyproline to the diet of GHS rats led to an increase in urinary oxalate excretion, which did not increase further with the provision of additional hydroxyproline. The addition of 1% and 3% hydroxyproline did not alter calcium excretion while the provision of 5% hydroxyproline led to a decrease in urine calcium excretion. The addition of 1% hydroxyproline led to an increase in urinary calcium oxalate supersaturation, which did not further increase with additional hydroxyproline. The addition of 1% and 3% hydroxyproline did not alter urinary supersaturation with respect to calcium hydrogen phosphate while the addition of 5% hydroxyproline tended to lower this supersaturation. Compared to rats fed the control and the 3% hydroxyproline diet the addition of 5% hydroxyproline increased the ratio of calcium oxalate supersaturation to calcium phosphate supersaturation. Virtually all rats formed stones. In the control and 1% hydroxyproline group, all of the stones were composed of calcium and phosphate (apatite), in the 3% hydroxyproline group the stones were a mixture of apatite and calcium oxalate, while in the 5% hydroxyproline group all of the stones were calcium oxalate. CONCLUSIONS The provision of additional dietary hydroxyproline to GHS rats increases urinary oxalate excretion, calcium oxalate supersaturation and the ratio of calcium oxalate-to-calcium phosphate supersaturation, resulting in the formation of calcium oxalate kidney stones. Thus, with the addition of a common amino acid, the GHS rats now not only model the most common metabolic abnormality found in patients with nephrolithiasis, hypercalciuria, but form the most common type of kidney stone, calcium oxalate.
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Affiliation(s)
- David A Bushinsky
- Department of Medicine, Nephrology Unit, University of Rochester School of Medicine, Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, NY 14642, USA.
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Abstract
There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undernutrition, but this is a greater problem in those without a colon, as they do not derive energy from anaerobic bacterial fermentation of carbohydrate to short chain fatty acids in the colon. Patients with a jejunostomy have major problems of dehydration, sodium and magnesium depletion all due to a large volume of stomal output. Both types of patient have lost at least 60 cm of terminal ileum and so will become deficient of vitamin B12. Both groups have a high prevalence of gallstones (45%) resulting from periods of biliary stasis. Patients with a retained colon have a 25% chance of developing calcium oxalate renal stones and they may have problems with D (-) lactic acidosis. The survival of patients with a short bowel, even if they need long-term parenteral nutrition, is good.
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Affiliation(s)
- J M Nightingale
- Gastroenterology Centre, Leicester Royal Infirmary, United Kingdom.
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Affiliation(s)
- P.B.E. ALBIHN
- From the Department of Food Science, Swedish University of Agricultural Science, Uppsala, Sweden, and Food Group, Animal and Food Sciences Division, Lincoln University, Canterbury, New Zealand
| | - G.P. SAVAGE
- From the Department of Food Science, Swedish University of Agricultural Science, Uppsala, Sweden, and Food Group, Animal and Food Sciences Division, Lincoln University, Canterbury, New Zealand
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Selvam R, Kalaiselvi P, Govindaraj A, Bala Murugan V, Sathish Kumar AS. Effect of A. lanata leaf extract and Vediuppu chunnam on the urinary risk factors of calcium oxalate urolithiasis during experimental hyperoxaluria. Pharmacol Res 2001; 43:89-93. [PMID: 11207071 DOI: 10.1006/phrs.2000.0745] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Urolithiasis is one of the third most common afflictions found in humans. The efficacy of the two Siddha drugs, Aerva lanata and Vediuppu chunnam as antilithic agents using a urolithic rat model were tested in this study. Hyperoxaluria was induced in rats using 0.75% ethylene glycol in drinking water. Aerva lanata(3.0 mg kg(-1)body weight) and Vediuppu chunnam (3.5 mg kg(-1)body weight) were given orally for 28 days. Urinary risk factors of urolithiasis were monitored at the end of 7th, 14th, 21st and 28th days. Urinary volume was increased in hyperoxaluric as well as drug-treated rats. Increased urinary excretion of calcium, oxalate, uric acid, phosphorus and protein in hyperoxaluric rats was brought down significantly by the administration of A. lanata or Vediuppu chunnam. Decreased magnesium excretion in hyperoxaluric rats was normalized by drug treatment. The drug increases the urine volume, thereby reducing the solubility product with respect to calcium oxalate and other crystallizing salts such as uric acid, which may induce epitaxial deposition of calcium oxalate. Drug alone treated rats did not show any adverse effects. Combination therapy was found to be more effective and this indigenous medicine can be used successfully as an antilithic agent.
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Affiliation(s)
- R Selvam
- Department of Medical Biochemistry, Dr Alm PG Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai, 600 021, India
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Bushinsky DA, Bashir MA, Riordon DR, Nakagawa Y, Coe FL, Grynpas MD. Increased dietary oxalate does not increase urinary calcium oxalate saturation in hypercalciuric rats. Kidney Int 1999; 55:602-12. [PMID: 9987084 DOI: 10.1046/j.1523-1755.1999.00281.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Human calcium oxalate (CaOx) nephrolithiasis may occur if urine is supersaturated with respect to the solid-phase CaOx. In these patients, dietary oxalate is often restricted to reduce its absorption and subsequent excretion in an effort to lower supersaturation and to decrease stone formation. However, dietary oxalate also binds intestinal calcium which lowers calcium absorption and excretion. The effect of increasing dietary oxalate on urinary CaOx supersaturation is difficult to predict. METHODS To determine the effect of dietary oxalate intake on urinary supersaturation with respect to CaOx and brushite (CaHPO4), we fed 36th and 37th generation genetic hypercalciuric rats a normal Ca diet (1.2% Ca) alone or with sodium oxalate added at 0.5%, 1.0%, or 2.0% for a total of 18 weeks. We measured urinary ion excretion and calculated supersaturation with respect to the CaOx and CaHPO4 solid phases and determined the type of stones formed. RESULTS Increasing dietary oxalate from 0% to 2.0% significantly increased urinary oxalate and decreased urinary calcium excretion, the latter presumably due to increased dietary oxalate-binding intestinal calcium. Increasing dietary oxalate from 0% to 2.0% decreased CaOx supersaturation due to the decrease in urinary calcium offsetting the increase in urinary oxalate and the decreased CaHPO4 supersaturation. Each rat in each group formed stones. Scanning electron microscopy revealed discrete stones and not nephrocalcinosis. X-ray and electron diffraction and x-ray microanalysis revealed that the stones were composed of calcium and phosphate; there were no CaOx stones. CONCLUSION Thus, increasing dietary oxalate led to a decrease in CaOx and CaHPO4 supersaturation and did not alter the universal stone formation found in these rats, nor the type of stones formed. These results suggest the necessity for human studies aimed at determining the role, if any, of limiting oxalate intake to prevent recurrence of CaOx nephrolithiasis.
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Affiliation(s)
- D A Bushinsky
- Nephrology Unit, University of Rochester, New York, USA.
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Hassapidou MN, Paraskevopoulos STH, Karakoltsidis PA, Petridis D, Fotiadou E. Dietary habits of patients with renal stone disease in Greece. J Hum Nutr Diet 1999. [DOI: 10.1046/j.1365-277x.1999.00141.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND Oxalic acid-degrading bacteria have been isolated from human faces. Therefore, the possibility exists that oxalic acid in food is degraded in human intestine by such bacteria, and absorption and excretion of oxalic acid is reduced. It may be possible that patients who form idiopathic stones have fewer oxalic acid-degrading bacteria than healthy controls. The purpose of this study is to examine the possibility that oxalic acid in food is degraded in the human intestine. METHODS Nineteen patients with calcium stones and 13 healthy subjects were included in the study. Samples of feces were diluted with Barber medium containing 1 g/L of oxalic acid dihydrate, and 1%, 0.1% and 0.01% suspensions were prepared. These solutions were incubated under anaerobic conditions at 37 degrees C for seven days. The degradation of oxalic acid was estimated by the decrease of oxalic acid in the medium. RESULTS The feces of almost all persons with or without calculi degraded oxalic acid to some degree. Incomplete or no oxalic acid degradation was found in 15 of the 19 stone-forming patients and in five of the 13 stone-free controls. CONCLUSION Large numbers of oxalic acid-degrading bacteria were observed less often in the feces of stone-formers than in the feces of stone-free controls.
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Affiliation(s)
- H Ito
- Department of Urology, Teikyo University School of Medicine, Ichihara Hospital, Japan
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Ito H, Miura N, Masai M, Yamamoto K, Hara T. Reduction of oxalate content of foods by the oxalate degrading bacterium, Eubacterium lentum WYH-1. Int J Urol 1996; 3:31-4. [PMID: 8646596 DOI: 10.1111/j.1442-2042.1996.tb00626.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Urinary oxalate may contribute far more than urinary calcium to the pathogenesis of urinary calculi. Urinary oxalate may be reduced by restricting the intake of foods high in oxalate. The oxalate content foods might be reduced by oxalate-degrading bacteria. The purpose of this experiment was to reduce the oxalate content of foods with an oxalate-degrading bacterium which was isolated from the feces of Japanese male. METHODS An artificial intestinal juice was prepared by modifying Rogosa medium. An infusion of black tea was prepared from a commercial tea bag. The oxalate-degrading bacteria used were Eubacterium lentum WYH-1 which were have isolated. To 5 ml of the above oxalate-containing artificial intestinal juice and infusion of black tea, 0.5 ml of the bacterial culture was added and incubated anaerobically at 37 degrees C. Oxalic acid in the supernatant of the culture medium was assayed by high-performance liquid chromatography. RESULTS In 24 hours, 1 x 10(6) cells/ml of Eubacterium lentum WYH-1 decomposed 100% of 1 mg/ml oxalate in the artificial intestinal juice. The oxalate in the black tea infusion (1 mg/mL) was also decomposed completely within 48 hours by 1 x 10(7) cells/mL of bacteria. CONCLUSION Eubacterium lentum WYH-1 was able to efficiently decompose the oxalate in foods.
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Affiliation(s)
- H Ito
- Department of Urology, Teikyo University School of Medicine, Ichihara Hospital, Japan
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41
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Affiliation(s)
- C T Samuell
- Department of Chemical Pathology, University College London Hospitals, UK
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42
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McKay DW, Seviour JP, Comerford A, Vasdev S, Massey LK. Herbal tea: an alternative to regular tea for those who form calcium oxalate stones. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1995; 95:360-1. [PMID: 7860952 DOI: 10.1016/s0002-8223(95)00093-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- D W McKay
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Canada
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Massey LK, Roman-Smith H, Sutton RA. Effect of dietary oxalate and calcium on urinary oxalate and risk of formation of calcium oxalate kidney stones. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1993; 93:901-6. [PMID: 8335871 DOI: 10.1016/0002-8223(93)91530-4] [Citation(s) in RCA: 113] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Dietary restriction of oxalate intake has been used as therapy to reduce the risk of recurrence of calcium oxalate kidney stones. Although urinary oxalate is derived predominantly from endogenous synthesis, it may also be affected by dietary intake of oxalate and calcium. The risk of increasing urinary oxalate excretion by excessive consumption of dietary oxalate is greatest in individuals with a high rate of oxalate absorption, both with and without overt intestinal disease. Although oxalate-rich foods enhanced excretion of urinary oxalate in normal volunteers, the increase was not proportional to the oxalate content of the food. Only eight foods--spinach, rhubarb, beets, nuts, chocolate, tea, wheat bran, and strawberries--caused a significant increase in urinary oxalate excretion. Restriction of dietary calcium enhances oxalate absorption and excretion, whereas an increase in calcium intake may reduce urinary oxalate excretion by binding more oxalate in the gut. This review of the literature indicates that initial dietary therapy for stone-forming individuals can be limited to the restriction of foods definitely shown to increase urinary oxalate. The effects of oxalate-restricted diets on urinary oxalate should be evaluated by means of laboratory analyses of urine composition. Subsequent long-term therapy can be recommended if beneficial results are obtained from oxalate restriction at an appropriate calcium intake.
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Affiliation(s)
- L K Massey
- Washington State University, Spokane 99204-0399
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Affiliation(s)
- A Borsatti
- Istituto di Medicina Interna, Universitá di Padova, Italy
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Hanson CF, Frankos VH, Thompson WO. Bioavailability of oxalic acid from spinach, sugar beet fibre and a solution of sodium oxalate consumed by female volunteers. Food Chem Toxicol 1989; 27:181-4. [PMID: 2731814 DOI: 10.1016/0278-6915(89)90067-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Oxalate bioavailability from sugar beet fibre (40 g), spinach (25 g) and a solution of sodium oxalate (182 mg) was tested in nine women using a triplicated 3 x 3 Latin square arrangement. Each test substance provided 120 mg oxalic acid. Throughout the study the volunteers consumed a control diet and the test substances were administered at breakfast on specified days. After an initial 2-day control period, oxalate was administered in three test periods that consisted of one test day followed by one control day. Urine collected during 24-hr periods was analysed daily for oxalate. Oxalate excretion did not differ among the five control days and was not increased significantly following the ingestion of sugar beet fibre by the volunteers. Oxalate excretion was greater (P less than 0.0001) for the mean of the spinach and sodium oxalate solution diets than for the mean of the sugar beet fibre and control diets. Oxalate bioavailability from sugar beet fibre was 0.7% compared with bioavailabilities of 4.5 and 6.2% for spinach and oxalate solutions, respectively. The low bioavailability of oxalate from sugar beet fibre may be attributable to its high ratio of minerals (calcium and magnesium) to oxalate, its complex fibre matrix or the loss of the soluble oxalate during processing of sugar beets.
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Affiliation(s)
- C F Hanson
- Food, Nutrition and Institution Administration Department, Oklahoma State University, Stillwater 74078
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Rose GA. Plasma Oxalate and its Diurnal Variation and Renal Clearance. Urolithiasis 1989. [DOI: 10.1007/978-1-4899-0873-5_127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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