It Pays to Read the Old Dead Guy’s Papers: Triggering Doses of Oxalate and Calcium Oxalate Nephrocalcinosis

It has been hypothesized that high triggering doses of hyperoxaluria induce crystal formation, while lower maintenance doses promote crystal growth. We confirmed this using minipumps secreting 30 to 60 μmol potassium oxalate per day to induce modest, continuous hyperoxaluria for 28 days after the triggering dose (288 μmol oxalate) was given as an i.p. injection or infused over 24hr. Calcium oxalate crystal deposition was induced in 6/6 rats. This hypothesis could explain the modest clinical correlation between oxalate excretion and calcium oxalate stone disease.