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Conjugated bile acid replacement therapy reduces urinary oxalate excretion in short bowel syndrome.
- Source :
-
American journal of kidney diseases : the official journal of the National Kidney Foundation [Am J Kidney Dis] 2003 Jan; Vol. 41 (1), pp. 230-7. - Publication Year :
- 2003
-
Abstract
- Background: Patients with short bowel syndrome (SBS) have steatorrhea, in part because of bile acid malabsorption that causes decreased bile acid secretion into the duodenum and consequent fat maldigestion. In SBS patients with colon in continuity, luminal calcium forms calcium fatty acid soaps rather than precipitating as insoluble calcium oxalate. Soluble oxalate is hyperabsorbed by the colon leading to hyperoxaluria and an increased risk for renal calcium oxalate stones and deposits. The authors hypothesized that oral ingestion of conjugated bile acids would increase fat absorption and thereby decrease calcium fatty acid soap formation and oxalate hyperabsorption.<br />Methods: The effect of conjugated bile acid replacement therapy (9 g/d) on fecal fat excretion and urine oxalate excretion was measured in an appropriate patient, utilizing the metabolic balance technique. The effects of chronic bile acid replacement therapy on oxalate excretion and nutritional status also were measured in a 3-month outpatient study.<br />Results: Natural conjugated bile acid replacement therapy reduced fecal fat excretion from 119 to 79 g/d (Delta40 g/d), and urinary oxalate excretion from 87 to 64 mg/d (966 to 710 micromol/d; Delta23 mg/d). Cholylsarcosine, a synthetic conjugated bile acid, had similar but less powerful effects. During a 3-month outpatient trial of natural conjugated bile acids (9 g/d), urine oxalate decreased to normal levels (27 mg/d) in association with weight gain, decreased hunger, and decreased hyperphagia.<br />Conclusion: Conjugated bile acid replacement therapy reduced fecal fat excretion, reduced urinary oxalate excretion, and improved nutritional status in a patient with SBS with colon in continuity, hyperoxaluria, and oxalate nephrolithiasis.<br /> (Copyright 2003 by the National Kidney Foundation, Inc.)
- Subjects :
- Administration, Oral
Aged
Animals
Cattle
Celiac Disease diet therapy
Celiac Disease drug therapy
Celiac Disease metabolism
Celiac Disease urine
Cholic Acids administration & dosage
Feces chemistry
Humans
Hyperoxaluria diet therapy
Male
Outpatients
Sarcosine administration & dosage
Short Bowel Syndrome diet therapy
Short Bowel Syndrome metabolism
Short Bowel Syndrome urine
Urine chemistry
Calcium Oxalate urine
Cholic Acids therapeutic use
Hyperoxaluria drug therapy
Sarcosine analogs & derivatives
Sarcosine therapeutic use
Short Bowel Syndrome drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1523-6838
- Volume :
- 41
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of kidney diseases : the official journal of the National Kidney Foundation
- Publication Type :
- Academic Journal
- Accession number :
- 12500242
- Full Text :
- https://doi.org/10.1053/ajkd.2003.50012