Enteric Hyperoxaluria and Kidney Stone Management in Inflammatory Bowel Disease
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Gastroenterology for Geriatric Patients (A Afzali and S Katz, Section Editors)
Enteric Hyperoxaluria and Kidney Stone Management in Inflammatory Bowel Disease Elissa Lin, MD1,* Joseph Xu, MD1 Menghan Liu, MD1 Lama Nazzal, MD2 Seymour Katz, MD2 Address *,1 New York University Langone Health, New York, NY, 10016, USA Email: [email protected] 2 Department of Medicine, New York University Langone Health, New York, NY, 10016, USA
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Gastroenterology for Geriatric Patients Keywords IBD I Hyperoxaluria I Urolithiasis I Chronic kidney disease I Crohn’s disease I Ulcerative colitis
Abstract Purpose of review Enteric hyperoxaluria is frequently seen in patients with inflammatory bowel disease (IBD). IBD patients are therefore at higher risk of nephrolithiasis, particularly calcium oxalate stones. We reviewed the recent medical literature to elucidate the mechanisms and risk factors behind nephrolithiasis in IBD patients, as well as therapies to treat and prevent the formation of kidney stones. Recent findings At present, there are no specific guidelines for screening and monitoring the progression of nephrolithiasis in the IBD population. Yet, recent epidemiologic data suggests that the prevalence of nephrolithiasis in the adult IBD patients is as high as 28%. Enteric oxalate levels of IBD patients are significantly elevated compared with non-IBD patients, and recent studies have shown that the gut microbiota largely mediates this process. In particular, intestinal disruption and malabsorption in IBD patients lead to the decolonization of Oxalobacter formigenes which normally metabolizes oxalate in the gut lumen. As such, future studies are needed to clarify the role of O. formigenes in IBD patients with the goal of devising new therapeutic approaches for nephrolithiasis treatment and risk reduction. Summary Enteric hyperoxaluria plays a large role in nephrolithiasis, a serious extra-intestinal manifestation of IBD that may progress to chronic kidney disease. The gut microbiota offers a promising approach to treating and preventing hyperoxaluria in the IBD population.
Gastroenterology for Geriatric Patients (A Afzali and S Katz, Section Editors)
Introduction As the incidence of inflammatory bowel disease (IBD) increases [1], extra-intestinal manifestations of IBD are becoming more common. Nephrolithiasis is a common manifestation of urinary tract complications in IBD patients [2•]. Enteric hyperoxaluria is the main metabolic change responsible for urolithiasis in the IBD population although IBD medications and non-IBD
medications have also been implicated in the development of kidney stones [3]. Our review evaluates the pertinent data in the literature on nephrolithiasis, its complications in the adult patient with IBD, and medical management of novel therapies for the prevention of stone formation.
Incidence and prevalence In the general population, the prevalence of nephrolithiasis is estimat
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