Hyperoxaluria leads to calcium oxalate crystal formation and subsequent urolithiasis. This study aims to analyse the effect of treatment compliance in hyperoxaluria, firstly by analysis of patients with non-primary hyperoxaluria and secondly via systematic review in patients with any hyperoxaluria.

In a retrospective cohort study, adults with non-primary hyperoxaluria managed with dietary counselling in 2013 were enrolled. Twenty-four-hour (24 h) urine collections initially and at 6 months were obtained. Compliance was assessed by self-reported dietary compliance and 24 h urinary volume >2 L. Patients were followed for 24 months. Primary outcomes were urinary oxalate and calcium 24 h load at 6 months, and urolithiasis-related procedural rates at 24 months. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compatible systematic review of compliance among hyperoxaluric patients was performed.

In the cohort study, of 19 eligible patients (4 female) with median age 52 years, 10 (53%) were considered compliant. Compared with the non-compliant group, these patients had significantly increased subsequent 24 h urinary volume (2250 mL vs. 1600 mL; p = 0.008) and lower procedural rates (10% vs. 56%; p = 0.033). Subsequent 24 h urinary oxalate load was non-significantly lower in compliant patients. Systematic review regarding compliance in hyperoxaluric patients revealed five studies. Only one utilised dietary counselling or analysed compliant vs. non-compliant patients, finding no difference. None examined the effect of compliance on procedural rates.

Hyperoxaluria is an important cause of recurrent urolithiasis. Increasing fluid intake and reducing dietary oxalate reduce the risk of operative intervention and remain fundamental to the treatment of hyperoxaluria.

• Hyperoxaluria
• Metabolic stone disease
• Recurrent stone former
• Urolithiasis

• Bowel disease
• Lithiases urinaires
• Oxalobacter formigenes
• Pathologies digestives
• Urinary stones

• Bone Diseases/etiology
• Calcium Oxalate/metabolism
• Gallstones/etiology
• Gallstones/prevention & control
• Humans
• Kidney Calculi/etiology
• Liver Diseases/etiology
• Parenteral Nutrition/adverse effects
• Short Bowel Syndrome/complications

There are two common types of adult patient with a short bowel, those with jejunum in continuity with a functioning colon and those with a jejunostomy. Both groups have potential problems of undernutrition, but this is a greater problem in those without a colon, as they do not derive energy from anaerobic bacterial fermentation of carbohydrate to short chain fatty acids in the colon. Patients with a jejunostomy have major problems of dehydration, sodium and magnesium depletion all due to a large volume of stomal output. Both types of patient have lost at least 60 cm of terminal ileum and so will become deficient of vitamin B₁₂. Both groups have a high prevalence of gallstones (45%) resulting from periods of biliary stasis. Patients with a retained colon have a 25% chance of developing calcium oxalate renal stones and they may have problems with D (-) lactic acidosis. The survival of patients with a short bowel, even if they need long-term parenteral nutrition, is good.

• Short bowel syndrome
• Patients/statistics & numerical data

• Colon/physiopathology
• Digestive System/physiopathology
• Humans
• Jejunostomy
• Nutrition Disorders/etiology
• Risk Factors
• Short Bowel Syndrome/complications
• Short Bowel Syndrome/etiology
• Short Bowel Syndrome/physiopathology
• Short Bowel Syndrome/therapy

• Humans
• Hyperoxaluria/etiology
• Hyperoxaluria/metabolism
• Hyperoxaluria/therapy
• Oxalates/metabolism