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Oxalosis and Chronic Renal Failure After Intestinal Bypass

Oxalosis and Chronic Renal Failure After Intestinal Bypass Abstract A 45-year-old man underwent a jejunoileal shunt procedure for obesity. Twenty months later he developed severe oxalosis and chronic renal failure, which required maintenance hemodialysis. The sequential observation of two biopsy specimens and the necropsy (over a span of 39 months) suggests that oxalate deposition caused tubular obstruction and destruction with subsequent atrophy of nephrons. This indicates that patients undergoing intestinal bypass are at risk for developing irreversible renal failure due to enteric hyperoxaluria. (Arch Intern Med 137:239-243, 1977) References 1. Jehgers H, Murphy R: Practical aspects of oxalate metabolism . N Engl J Med 233:208-215, 238-246, 1945.Crossref 2. Frascino JA, Vanamee P, Rosen PP: Renal oxalosis and azotemia after methoxyflurane anesthesia . N Engl J Med 283:676-679, 1970.Crossref 3. Mazze RI, Trudell JR, Cousins MJ: Methoxyflurane metabolism and renal dysfunction: Clinical correlations in man . Anesthesiology 35:247-252, 1971.Crossref 4. Friedman EA, Greenberg JB, Merrill JP, et al: Consequences of ethylene glycol poisoning: Report of four cases and review of the literature . Am J Med 32:891-902, 1962.Crossref 5. Parry MF, Wallach R: Ethylene glycol Poisoning . Am J Med 57:143-150, 1974.Crossref 6. Dempsey EF, Forbes AP, Melick RA, et al: Urinary oxalate excretion . Metabolism 9:52-58, 1960. 7. Deren JJ, Porush JG, Levitt MF, et al: Nephrolithiasis as a complication of ulcerative colitis and regional enteritis . Ann Intern Med 56:843-853, 1962.Crossref 8. Gelzayd EA, Breuer RI, Kirsner JB: Nephrolithiasis in inflammatory bowel disease . Am J Dig Dis 13:1027-1034, 1968.Crossref 9. Admirand WH, Earnest DL, Williams HE: Hyperoxaluria and bowel disease . Trans Assoc Am Physicians 84:307-312, 1971. 10. Dowling RH, Rose GA, Sutor DJ: Hyperoxaluria and renal calculi in ileal disease . Lancet 1:1103-1106, 1971.Crossref 11. Smith LH, Fromm H, Hoffman AF: Acquired hyperoxaluria, nephrolithiasis, and intestinal disease: Description of a syndrome . N Engl J Med 286:1371-1375, 1972.Crossref 12. O'Leary JP, Thomas WC, Woodward ER: Urinary tract stone after small bowel bypass for morbid obesity . Am J Surg 127:142-147, 1974.Crossref 13. Cryer PE, Garber AJ, Hoffsten P, et al: Renal failure after small intestinal bypass for obesity . Arch Intern Med 135:1610-1612, 1975.Crossref 14. Williams HE, Smith LH: Disorders of oxalate metabolism . Am J Med 45:715-735, 1968.Crossref 15. Hodgkinson A, Zarembski PM: Oxalic acid metabolism in man: A review . Calcif Tissue Res 2:115-132, 1968.Crossref 16. Hagler H, Herman RH: Oxalate metabolism I-IV . Am J Clin Nutr 26:758-765, 882-889, 1006-1010, 1073-1079, 1973. 17. Williams HE, Smith LH: Primary hyperoxaluria in Stanbury JB, Wyngaarden JB, Fredrickson DS (eds): The Metabolic Basis of Inherited Disease , ed 3. New York, McGraw-Hill Book Co Inc, 1972, pp 196-219. 18. Vainder M, Kelly J: Renal tubular dysfunction secondary to jejunoileal bypass . JAMA 235:1257-1258, 1976.Crossref 19. Hoffman AF, Tacker MM, Fromm H, et al: Acquired hyperoxaluria and intestinal disease: Evidence that bile acid glycine is not a precursor of oxalate . Mayo Clin Proc 48:35-42, 1973. 20. Chadwick VS, Modha K, Dowling RH: Mechanisms for hyperoxaluria in patients with ileal dysfunction . N Engl J Med 289:172-176, 1973.Crossref 21. Stauffer JQ, Humphreys MH, Weir GJ: Acquired hyperoxaluria with regional enteritis after ileal resection: Role of dietary oxalate . Ann Intern Med 79:383-391, 1973.Crossref 22. Earnest DL, Johnson G, Williams HE, et al: Hyperoxaluria in patients with ileal resection: An abnormality in dietary oxalate absorption . Gastroenterology 66:1114-1122, 1974. 23. Andersson H, Jagenburg R: Fat-reduced diet in the treatment of hyperoxaluria in patients with ileopathy . Gut 15:360-366, 1974.Crossref 24. Dobbins JW, Binder HJ: Effects of bile salts and fatty acids on the colonic absorption of oxalate . Gastroenterology 70:1096-1100, 1976. 25. Deodhar S, Tung K, Zuhlke V, et al: Renal homotransplantation in a patient with primary familial oxalosis . Arch Pathol 87:118-124, 1969. 26. Klawers J, Wolf P, Cohn R: Failure of renal transplantation in primary oxalosis . JAMA 209:551, 1969.Crossref 27. Scowen E, Stansfield A, Watts R: Oxalosis and primary hyperoxaluria . J Pathol 77:195-205, 1959.Crossref 28. Koten JW, Van Gastel C, Dorhout Mees EJ, et al: Two cases of primary oxalosis . J Clin Pathol 18:223-229, 1965.Crossref 29. Kosek JC, Mazze RI, Cousins MJ: The morphology and pathogenesis of nephrotoxicity following methoxyflurane (Penthrane) anesthesia: An experimental model in rats . Lab Invest 27:575-580, 1972. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Oxalosis and Chronic Renal Failure After Intestinal Bypass

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References (29)

Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1977.03630140085017
Publisher site
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Abstract

Abstract A 45-year-old man underwent a jejunoileal shunt procedure for obesity. Twenty months later he developed severe oxalosis and chronic renal failure, which required maintenance hemodialysis. The sequential observation of two biopsy specimens and the necropsy (over a span of 39 months) suggests that oxalate deposition caused tubular obstruction and destruction with subsequent atrophy of nephrons. This indicates that patients undergoing intestinal bypass are at risk for developing irreversible renal failure due to enteric hyperoxaluria. (Arch Intern Med 137:239-243, 1977) References 1. Jehgers H, Murphy R: Practical aspects of oxalate metabolism . N Engl J Med 233:208-215, 238-246, 1945.Crossref 2. Frascino JA, Vanamee P, Rosen PP: Renal oxalosis and azotemia after methoxyflurane anesthesia . N Engl J Med 283:676-679, 1970.Crossref 3. Mazze RI, Trudell JR, Cousins MJ: Methoxyflurane metabolism and renal dysfunction: Clinical correlations in man . Anesthesiology 35:247-252, 1971.Crossref 4. Friedman EA, Greenberg JB, Merrill JP, et al: Consequences of ethylene glycol poisoning: Report of four cases and review of the literature . Am J Med 32:891-902, 1962.Crossref 5. Parry MF, Wallach R: Ethylene glycol Poisoning . Am J Med 57:143-150, 1974.Crossref 6. Dempsey EF, Forbes AP, Melick RA, et al: Urinary oxalate excretion . Metabolism 9:52-58, 1960. 7. Deren JJ, Porush JG, Levitt MF, et al: Nephrolithiasis as a complication of ulcerative colitis and regional enteritis . Ann Intern Med 56:843-853, 1962.Crossref 8. Gelzayd EA, Breuer RI, Kirsner JB: Nephrolithiasis in inflammatory bowel disease . Am J Dig Dis 13:1027-1034, 1968.Crossref 9. Admirand WH, Earnest DL, Williams HE: Hyperoxaluria and bowel disease . Trans Assoc Am Physicians 84:307-312, 1971. 10. Dowling RH, Rose GA, Sutor DJ: Hyperoxaluria and renal calculi in ileal disease . Lancet 1:1103-1106, 1971.Crossref 11. Smith LH, Fromm H, Hoffman AF: Acquired hyperoxaluria, nephrolithiasis, and intestinal disease: Description of a syndrome . N Engl J Med 286:1371-1375, 1972.Crossref 12. O'Leary JP, Thomas WC, Woodward ER: Urinary tract stone after small bowel bypass for morbid obesity . Am J Surg 127:142-147, 1974.Crossref 13. Cryer PE, Garber AJ, Hoffsten P, et al: Renal failure after small intestinal bypass for obesity . Arch Intern Med 135:1610-1612, 1975.Crossref 14. Williams HE, Smith LH: Disorders of oxalate metabolism . Am J Med 45:715-735, 1968.Crossref 15. Hodgkinson A, Zarembski PM: Oxalic acid metabolism in man: A review . Calcif Tissue Res 2:115-132, 1968.Crossref 16. Hagler H, Herman RH: Oxalate metabolism I-IV . Am J Clin Nutr 26:758-765, 882-889, 1006-1010, 1073-1079, 1973. 17. Williams HE, Smith LH: Primary hyperoxaluria in Stanbury JB, Wyngaarden JB, Fredrickson DS (eds): The Metabolic Basis of Inherited Disease , ed 3. New York, McGraw-Hill Book Co Inc, 1972, pp 196-219. 18. Vainder M, Kelly J: Renal tubular dysfunction secondary to jejunoileal bypass . JAMA 235:1257-1258, 1976.Crossref 19. Hoffman AF, Tacker MM, Fromm H, et al: Acquired hyperoxaluria and intestinal disease: Evidence that bile acid glycine is not a precursor of oxalate . Mayo Clin Proc 48:35-42, 1973. 20. Chadwick VS, Modha K, Dowling RH: Mechanisms for hyperoxaluria in patients with ileal dysfunction . N Engl J Med 289:172-176, 1973.Crossref 21. Stauffer JQ, Humphreys MH, Weir GJ: Acquired hyperoxaluria with regional enteritis after ileal resection: Role of dietary oxalate . Ann Intern Med 79:383-391, 1973.Crossref 22. Earnest DL, Johnson G, Williams HE, et al: Hyperoxaluria in patients with ileal resection: An abnormality in dietary oxalate absorption . Gastroenterology 66:1114-1122, 1974. 23. Andersson H, Jagenburg R: Fat-reduced diet in the treatment of hyperoxaluria in patients with ileopathy . Gut 15:360-366, 1974.Crossref 24. Dobbins JW, Binder HJ: Effects of bile salts and fatty acids on the colonic absorption of oxalate . Gastroenterology 70:1096-1100, 1976. 25. Deodhar S, Tung K, Zuhlke V, et al: Renal homotransplantation in a patient with primary familial oxalosis . Arch Pathol 87:118-124, 1969. 26. Klawers J, Wolf P, Cohn R: Failure of renal transplantation in primary oxalosis . JAMA 209:551, 1969.Crossref 27. Scowen E, Stansfield A, Watts R: Oxalosis and primary hyperoxaluria . J Pathol 77:195-205, 1959.Crossref 28. Koten JW, Van Gastel C, Dorhout Mees EJ, et al: Two cases of primary oxalosis . J Clin Pathol 18:223-229, 1965.Crossref 29. Kosek JC, Mazze RI, Cousins MJ: The morphology and pathogenesis of nephrotoxicity following methoxyflurane (Penthrane) anesthesia: An experimental model in rats . Lab Invest 27:575-580, 1972.

Journal

Archives of Internal Medicine – American Medical Association

Published: Feb 1, 1977

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