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Submitted: 09 Dec 2020
Accepted: 06 Feb 2021
ePublished: 12 Mar 2021
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J Renal Inj Prev. 2021;10(3): e19.
doi: 10.34172/jrip.2021.19
  Abstract View: 65
  PDF Download: 40

Original

A potential role of fecal oxalate-degrading activity in oxalate homeostasis in end-stage renal disease patients; a descriptive pilot study

Natalia Stepanova 1 * ORCID logo, Ganna Tolstanova 2 ORCID logo, Lesya Korol 1 ORCID logo, Iryna Akulenko 2 ORCID logo, Olena Savchenko 1 ORCID logo, Mykola Kolesnyk 1 ORCID logo

1 State Institution “Institute of Nephrology of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
2 Taras Shevchenko National University of Kyiv, Kyiv, Ukraine

Abstract

Introduction: End-stage renal disease (ESRD) patients have significant differences in plasma oxalic acid (POx) concentration under the same treatment conditions.

Objectives: In the present study, we adopted the method of redoximetric titration with a KMnO4 solution to evaluate the effect of total fecal oxalate-degrading activity (ODA) on oxalate homeostasis in ESRD patients which has never been reported before.

Patients and Methods: A total of 56 participants were enrolled in this cross-sectional pilot study, including 24 healthy volunteers (a control reference group) and 32 ESRD patients. Among the ESRD patients, there were 21 hemodialysis (HD) and 11 peritoneal dialysis (PD) patients. Total ODA in fecal samples as well as POx concentration, daily urinary oxalate (UOx) and PD effluent oxalate excretion were determined. Cohen’s d was computed to calculate the effect size using post-hoc analysis.

Results: Total ODA in fecal microbiota ranged from -23 to 24%/0.01 g of feces and was statistically higher in healthy volunteers compared with the ESRD patients. The ESRD patients with positive total fecal ODA status had higher UOx excretion level and lower POx concentration compared with the patients with negative total fecal ODA status. Cohen’s d effect size was 1.99 and 1.05, respectively. Total fecal ODA was an independent risk factor associated with POx elevation in the ESRD patients.

Conclusion: Our pilot study firstly demonstrated a potential role of total fecal ODA in oxalate homeostasis in ESRD patients. The results might be useful for determining sample size considerations and providing groundwork for future research projects.


Keywords: Oxalic acid, Hyperoxaluria, Fecal microbiota, End-stage renal disease, Total oxalate-degrading activity, Oxalate homeostasis

Implication for health policy/practice/research/medical education:

► The method of redoximetric titration with a KMnO4 solution is a new approach to the determination of total ODA in fecal microbiota.

► Total ODA in fecal microbiota is statistically higher in the healthy volunteers compared with ESRD patients. PD patients have a significantly lower total fecal ODA compared with HD patients.

► Total fecal ODA is an independent risk factor associated with plasma oxalic acid elevation in ESRD patients.

Please cite this paper as: Stepanova N, Tolstanova G, Korol L, Akulenko I, Savchenko O, Kolesnyk M. A potential role of fecal oxalate-degrading activity in oxalate homeostasis in end-stage renal disease patients; a descriptive pilot study. J Renal Inj Prev. 2021; 10(3): e19. doi: 10.34172/jrip.2021.19.

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