Hyperoxaluric nephrolithiasis is a complication of Roux-en-Y gastric bypass surgery

M. K. Sinha, M. L. Collazo-Clavell, A. Rule, D. S. Milliner, W. Nelson, M. G. Sarr, R. Kumar, J. C. Lieske

Research output: Contribution to journalArticle

163 Scopus citations

Abstract

Roux-en-Y bypass surgery is the most common bariatric procedure currently performed in the United States for medically complicated obesity. Although this leads to a marked and sustained weight loss, we have identified an increasing number of patients with episodes of nephrolithiasis afterwards. We describe a case series of 60 patients seen at Mayo Clinic-Rochester that developed nephrolithiasis after Roux-en-Y gastric bypass (RYGB), including a subset of 31 patients who had undergone metabolic evaluation in the Mayo Stone Clinic. The mean body mass index of the patients before procedure was 57 kg/m2 with a mean decrease of 20 kg/m2 at the time of the stone event, which averaged 2.2 years post-procedure. When analyzed, calcium oxalate stones were found in 19 and mixed calcium oxalate/uric acid stones in two patients. Hyperoxaluria was a prevalent factor even in patients without a prior history of nephrolithiasis, and usually presented more than 6 months after the procedure. Calcium oxalate supersaturation, however, was equally high in patients less than 6 months post-procedure due to lower urine volumes. In a small random sampling of patients undergoing this bypass procedure, hyperoxaluria was rare preoperatively but common 12 months after surgery. We conclude that hyperoxaluria is a potential complicating factor of RYGB surgery manifested as a risk for calcium oxalate stones.

Original languageEnglish (US)
Pages (from-to)100-107
Number of pages8
JournalKidney international
Volume72
Issue number1
DOIs
StatePublished - Jul 1 2007

Keywords

  • Bariatric surgery
  • Enteric hyperoxaluria
  • Nephrolithiasis
  • Obesity
  • Oxalate
  • Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Nephrology

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