2. Oxalic acid or oxalate is a naturally occurring metabolite that is a conseque

Question

2.   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.

3001 250 200 150 y 28.25 + 4.84 x r0.82 50- IO 20 30 40 50 Fecol fat 9/24 h Fig. 1 Comparison of faecal fat excretion with daily urinary oxalate excretion in six patients with sprue.

Explanation / Answer

Calcium oxalate stones are caused by too much oxalate in the urine and are most common type of kidney stones.

How are calciom oxalate stones formed - Oxalate is a natural substance found in many foods. Your body uses food for energy. After your body uses what it needs, waste products travel through the bloodstream to the kidneys and are removed through urine. Urine has various wastes in it. If there is too much waste in too little liquid, crystals can begin to form. These crystals may stick together and form a solid mass (a kidney stone). This can happen if there is too much oxalate, too little liquid, and the oxalate “sticks” to calcium while urine is being made by the kidneys.

RISK FACTORS -

Also patients with DIGESTIVE SYSTEM disorders like chronic pancreatitis , inflammatory bowel disease like chrohns and ulcerative colitis or sprue as in the graphical representaion there is an increase chances of calcium oxalate stone formation.

ORLISTAT -

It is important to know that kidney stones are more common if you have Inflammatory Bowel Disease (IBD). These conditions affect your body’s ability to absorb fats properly. When fat is not absorbed the right way, the fat binds to calcium and leaves oxalate behind. The oxalate is then absorbed and taken to the kidney, where it can form stones. Similarly, following gastric bypass surgery, your body absorbs less calcium from your digestive system. Because of this, higher levels of oxalate are found in the urinary tract. The build-up of oxalate can form crystals, which can form kidney stones.

Orlistat blocks some of the fat that you eat, keeping it from being absorbed by your body.

Orlistat is used to aid in weight loss, or to help reduce the risk of regaining weight already lost. its an intestinal and pancrteatic lipase inhibitor. so therefore as explained above the fat is poorly absorbed by the body and it binds to calcium leaving behind oxalate which is then absorbed by the kidney where in long duration of medicine intake can lead to oxalate stones formation.

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