Nephropathy in dietary hyperoxaluria:A potentially preventable acute or chronic kidney disease  

作　　者：Robert H Glew Yijuan Sun Bruce L Horowitz Konstantin N Konstantinov Marc Barry Joanna R Fair Larry Massie Antonios H Tzamaloukas 

机构地区：[1]Department of Surgery,University of New Mexico School of Medicine [2]Renal Section,Raymond G Murphy Veterans Affairs (VA) Medical Center and Department of Medicine,University of New Mexico School of Medicine [3]Division of Nephrology,Department of Medicine,University of New Mexico School of Medicine [4]Rheumatology Section,Raymond G Murphy VA Medical Center and Department of Medicine,University of New Mexico School of Medicine [5]Department of Pathology,University of New Mexico School of Medicine [6]Radiology Service,Raymond G Murphy VA Medical Center and Department of Radiology,University of New Mexico School of Medicine [7]Pathology Section,Raymond G Murphy VA Medical Center and Department of Pathology,University of New Mexico School of Medicine

出　　处：《World Journal of Nephrology》2014年第4期122-142,共21页世界肾病学杂志（英文版）

摘　　要：Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis,but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma,profound tubular damage and interstitial inflammation and fibrosis.Hyperoxaluric nephropathy presents clinically as acute or chronic renal failure that may progress to endstage renal disease(ESRD).This sequence of events,well recognized in the past in primary and enteric hyperoxalurias,has also been documented in a few cases of dietary hyperoxaluria.Estimates of oxalate intake in patients with chronic dietary hyperoxaluria who developed chronic kidney disease or ESRD were comparable to the reported average oxalate content of the diets of certain populations worldwide,thus raising the question whether dietary hyperoxaluria is a primary cause of ESRD in these regions.Studies addressing this question have the potential of improving population health and should be undertaken,alongside ongoing studies which are yielding fresh insights into the mechanisms of intestinal absorption and renal excretion of oxalate,and into the mechanisms of development of oxalate-induced renal parenchymal disease.Novel preventive and therapeutic strategies for treating all types of hyperoxaluria are expected to develop from these studies.Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis, but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma, profound tubular damage and interstitial inflammation and fibrosis. Hyperoxaluric nephropathy presents clinically as acute or chronic renal failure that may progress to endstage renal disease （ESRD）. This sequence of events, well recognized in the past in primary and enteric hyperoxalurias, has also been documented in a few cases of dietary hyperoxaluria. Estimates of oxalate intake in patients with chronic dietary hyperoxaluria who developed chronic kidney disease or ESRD were comparable to the reported average oxalate content of the diets of certain populations worldwide, thus raising the question whether dietary hyperoxaluria is a primary cause of ESRD in these regions. Studies addressing this question have the potential of improving population health and should be undertaken, alongside ongoing studies which are yielding fresh insights into the mechanisms of intestinal absorption and renal excretion of oxalate, and into the mechanisms of development of oxalate-induced renal parenchymal disease. Novel preventive and thera- peutic strategies for treating all types of hyperoxaluria are expected to develop from these studies.

关 键 词：Dietary hyperoxaluria Chronic oxalatenephropathy Acute oxalate nephropathy Acute tubular necrosis Interstitial nephritis NEPHROCALCINOSIS Calcium oxalate nephrolithiasis Oxalate transporters Inflammasomes 

分 类 号：R692.4[医药卫生—泌尿科学]