Objectives
To better understand intestinal oxalate transport by correlating oxalate and sucralose
absorption in idiopathic calcium oxalate stone formers. Oxalate has been hypothesized
to undergo absorption in the large and small intestine by both paracellular and transepithelial
transport. Sucralose is a chlorinated sugar that is absorbed by paracellular mechanisms.
Methods
Idiopathic calcium oxalate stone formers were recruited to provide urine specimens
on both a self-selected diet and after a meal containing 90 mg of 13C2-oxalate and 5 g of sucralose, and a stool sample for determination of Oxalobacter formigenes colonization. The 24-hour urine collections were fractionated into the first 6 hours
and the subsequent 18 hours. Sucralose and oxalate excretion were measured during
these periods and used to estimate absorption.
Results
Thirty-eight subjects were evaluated. The majority of both the 13C2-oxalate and sucralose absorption occurred within the 0-6-hour collection. The 13C2-oxalate and sucralose absorptions were significantly correlated at the 0-6 hour, the
6-24 hour, and the total 24-hour time periods (P <.04). All 5 oxalate hyperabsorbers(>15% absorption) also absorbed significantly
more sucralose during the 0-6 hour and whole 24-hour time points (P <.04). Oxalobacter formigenes colonization did not significantly alter oxalate absorption.
Conclusions
The results suggest that most oxalate is absorbed in the proximal portion of the gastrointestinal
tract and that paracellular transport is involved. Augmented paracellular transport,
as evidenced by increased sucralose absorption, may also influence oxalate absorption.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Contribution of dietary oxalate to urinary oxalate excretion.Kidney Int. 2001; 59: 270
- Estimation of the oxalate content of foods and daily oxalate intake.Kid Intl. 2000; 57: 1662
- Intestinal hyperabsorption of oxalate in calcium oxalate stone formers: application of a new test With [13C2] oxalate.J Am Soc Nephrol. 1999; 10: S229-S333
- 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: 1711
- 24-h uric acid excretion and the risk of kidney stones.Kidney Int. 2008; 73: 489
- The roles and mechanisms of intestinal oxalate transport in oxalate homeostasis.Semin Nephrol. 2008; 28: 143
- Urolithiasis and hepatotoxicity are linked to the anion transporter SatI in mice.J Clin Invest. 2010; 120: 706
- Ileal oxalate absorption and urinary oxalate excretion are enhanced in Slc26a6 null mice.Am J Physiol Gastrointest Liver Physiol. 2006; 290: G719
- Calcium oxalate urolithiasis in mice lacking anion transporter Slc26a6.Nat Genet. 2006; 38: 474
- Dietary oxalate loads and renal oxalate handling.J Urol. 2005; 174: 943
- Discrimination of site-specific alterations in gastrointestinal permeability in the rat.Gastroenterology. 1998; 114: 83
- Oxalobacter sp. reduces urinary oxalate excretion by promoting enteric oxalate secretion.Kidney Int. 2006; 69: 691
- Diet, but not oral probiotics, effectively reduces urinary oxalate excretion and calcium oxalate supersaturation.Kidney Int. 2010; 78: 1178
- Variability of gastrointestinal transit in healthy women and men.Gut. 1996; 39: 299
- Intestinal permeability: an overview.Gastroenterology. 1995; 108: 1566
- Assessment of oxalate absorption from almonds and black beans with and without the use of an extrinsic label.J Urol. 2004; 172: 953
- Susceptibility to gut leakiness: a possible mechanism for endotoxaemia in non-alcoholic steatohepatitis.Liver Int. 2008; 28: 1026
- Gas chromatographic method for detection of urinary sucralose: application to the assessment of intestinal permeability.J Chromatogr B Anal Technol Biomed Life Sci. 2003; 784: 145
- Intestinal transport of an obdurate anion: oxalate.Urol Res. 2005; 33: 1
- Oxalobacter formigenes may reduce the risk of calcium oxalate kidney stones.J Am Soc Nephrol. 2008; 19: 1197
- Intestinal mucosal barrier function in health and disease.Nat Rev Immunol. 2009; 9: 799
- Evaluation of a triple sugar test of colonic permeability in humans.Acta Physiol Scand. 2004; 182: 171
Article info
Publication history
Published online: June 15, 2011
Accepted:
April 4,
2011
Received:
February 4,
2011
Footnotes
Funding Support: This work was supported by NIH grant DK62284.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
