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. 2023 Mar;38(3):781-789.
doi: 10.1007/s00467-022-05674-3. Epub 2022 Jul 8.

Risk factors for developing hyperoxaluria in children with Crohn's disease

Amr Salem  1 , Happy Sawires  2 , Ayman Eskander  3 , Radwa Marwan  4 , Engy Boshra  3
Affiliations

Risk factors for developing hyperoxaluria in children with Crohn's disease

Amr Salem et al. Pediatr Nephrol. 2023 Mar.

Abstract

Background: For the purpose of a better understanding of enteric hyperoxaluria in Crohn's disease (CD) in children and adolescents, we investigated the occurrence and risk factors for development of hyperoxaluria in those patients.

Methods: Forty-five children with CD and another 45 controls were involved in this cross-sectional study. Urine samples were collected for measurement of spot urine calcium/creatinine (Ur Ca/Cr), oxalate/creatinine (Ur Ox/Cr), and citrate/creatinine (Ur Citr/Cr) ratios. Fecal samples were also collected to detect the oxalyl-CoA decarboxylase of Oxalobacter formigenes by PCR. Patients were classified into 2 groups: group A (with hyperoxaluria) and group B (with normal urine oxalate excretion). The disease extent was assessed, and the activity index was calculated.

Results: According to the activity index, 30 patients (66.7%) had mild disease and 13 patients (28.9%) had moderate disease. There was no significant difference in Ur Ox/Cr ratio regarding the disease activity index. O. formigenes was not detected in 91% of patients in group A while it was detected in all patients in group B (p < 0.001). By using logistic regression analysis, the overall model was statistically significant when compared to the null model, (χ2 (7) = 52.19, p < 0.001), steatorrhea (p = 0.004), frequent stools (p = 0.009), and O. formigenes (p < 0.001).

Conclusion: Lack of intestinal colonization with O. formigenes, steatorrhea, and frequent stools are the main risk factors for development of enteric hyperoxaluria in CD patients. Identifying risk factors facilitates proper disease management in future studies. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: Crohn’s disease; Hyperoxaluria; Malabsorption; Nephrolithiasis; Urine oxalate/creatinine ratio.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Urinary calcium, oxalate, and citrate excretion in patients and control group (percentage)
Fig. 2
Fig. 2
Boxplot of means of urine oxalate/creatinine ratio according to activity index in patient group
Fig. 3
Fig. 3
Correlations between serum calcium and urine calcium/creatinine ratio with urine oxalate/creatinine ratio
See this image and copyright information in PMC

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