Oxalate in Renal Stone Disease: The Terminal Metabolite That Just Won't Go Away

Susan R. Marengo; Andrea M. P. Romani


Nat Clin Pract Nephrol. 2008;4(7):368-377. 

In This Article


Traditionally, oxalate has been relegated to the status of a metabolic by-product, the role of which in stone disease is limited to the physical chemistry of crystallization. Recent investigations indicate, however, that oxalate can increase chloride, water, and sodium reabsorption in the proximal tubule and activate multiple signaling pathways in renal epithelial cells. By contrast, little is known about the partitioning of oxalate between urinary excretion, fecal excretion, and accumulation in tissues and organs. Until the factors that control this partitioning are understood, preventive medical therapies will elude patients with idiopathic hyperoxaluria, or with hyperoxaluria secondary to bariatric surgery or cystic fibrosis.

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