Oxalic acid or oxalate is a naturally occurring metabolite that is a consequence
ID: 3480548 • Letter: O
Question
Oxalic acid or oxalate is a naturally occurring metabolite that is a consequence of incomplete carbohydrate metabolism. Oxalates can be derived from diet most recent evidence suggests that another considerable source of oxalate is from the metabolism of ascorbic acid (vitamin C) by oxalate-producing bacteria within the gut microbiota. Hyperoxaluria can lead to urinary calcium oxalate supersaturation, and eventually the formation and retention of calcium oxalate crystals. Oxalates in blood complex with calcium to form crystalline composites that are capable of developing into kidney stones.
a. Interpret the following data related to urinary oxalate levels.
b. Explain mechanistically the data above. If you find literature that supports your argument, be sure to include the citation.
c. There is a slight increase in the risk of oxalate kidney stones in patients taking Orlistat, which is an intestinal and pancreatic lipase inhibitor, as a diet weight-loss drug. Describe a potential connection between Orlistat and increase risk of oxalate kidney stones.
d. Explain why as many as 50% of patients with chronic pancreatitis develop oxalate kidney stones.
Explanation / Answer
A) As the concentration of fat in faeces increase, there is increase in urinary oxalate levels.
B) The given data indicates that there is a positive correlation between urinary oxalate and concentration of faecal fat (r = 0.82).
C) Orlisrat increases the concentration of unabsorbed fat and bile acids in the intestinal lumen. These react with calcium in the intestinal lumen, limiting the amount of free calcium binding with oxalate and thereby raising intestinal oxalate absorption leading to hyperoxaluria, which can promote formation of oxalate stones.
D) About 50% of patients of chronic pancreatitis develop oxalate kidney stones because of the increased absorption of oxalate from intestines leading to hyperoxaluria and subsequent oxalate kidney stones.
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