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Open AccessArticle

Plasma Oxalate as a Predictor of Kidney Function Decline in a Primary Hyperoxaluria Cohort

1
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
2
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA
3
Division of Pediatric Nephrology, Mayo Clinic, Rochester, MN 55905, USA
4
Division of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2020, 21(10), 3608; https://doi.org/10.3390/ijms21103608
Received: 1 April 2020 / Revised: 15 May 2020 / Accepted: 16 May 2020 / Published: 20 May 2020
This retrospective analysis investigated plasma oxalate (POx) as a potential predictor of end-stage kidney disease (ESKD) among primary hyperoxaluria (PH) patients. PH patients with type 1, 2, and 3, age 2 or older, were identified in the Rare Kidney Stone Consortium (RKSC) PH Registry. Since POx increased with falling estimated glomerular filtration rate (eGFR), patients were stratified by chronic kidney disease (CKD) subgroups (stages 1, 2, 3a, and 3b). POx values were categorized into quartiles for analysis. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for risk of ESKD were estimated using the Cox proportional hazards model with a time-dependent covariate. There were 118 patients in the CKD1 group (nine ESKD events during follow-up), 135 in the CKD 2 (29 events), 72 in CKD3a (34 events), and 45 patients in CKD 3b (31 events). During follow-up, POx Q4 was a significant predictor of ESKD compared to Q1 across CKD2 (HR 14.2, 95% CI 1.8–115), 3a (HR 13.7, 95% CI 3.0–62), and 3b stages (HR 5.2, 95% CI 1.1–25), p < 0.05 for all. Within each POx quartile, the ESKD rate was higher in Q4 compared to Q1–Q3. In conclusion, among patients with PH, higher POx concentration was a risk factor for ESKD, particularly in advanced CKD stages. View Full-Text
Keywords: plasma oxalate; primary hyperoxaluria; estimated glomerular filtration rate; chronic kidney disease; Urine Oxalate; end-stage renal disease plasma oxalate; primary hyperoxaluria; estimated glomerular filtration rate; chronic kidney disease; Urine Oxalate; end-stage renal disease
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Shah, R.J.; Vaughan, L.E.; Enders, F.T.; Milliner, D.S.; Lieske, J.C. Plasma Oxalate as a Predictor of Kidney Function Decline in a Primary Hyperoxaluria Cohort. Int. J. Mol. Sci. 2020, 21, 3608.

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