Urinary oxalate excretion increases in home parenteral nutrition patients on a higher intravenous ascorbic acid dose

Lourdes Peña De La Vega, John C Lieske, Dawn Milliner, Janelle Gonyea, Darlene G. Kelly

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Vitamin C can be metabolized to oxalate. Case reports have suggested an association between IV vitamin C and urinary oxalate excretion. Recently, the US Food and Drug Administration required the dose of vitamin C in IV multivitamin preparations to be increased from 100 mg to 200 mg/d. We compared the urinary oxalate excretion level in stable home total parenteral nutrition (TPN) patients receiving both doses of vitamin C. Methods: Each participant provided a 24-hour urine sample for oxalate determination on the vitamin C dose (100 mg/d), and again after at least 1 month on the increased vitamin C dose (200 mg/d). A 2-day diet diary was completed covering the day before and the day of the urine collection and was analyzed for oxalate and vitamin C content. Comparisons were made using Student paired t test and Wilcoxon signed rank. Results: Thirteen patients (7 males/6 females) aged 63.1 ± 12.2 years who had no history of nephrolithiasis and had received TPN for 55.9 ± 78.8 months were enrolled. The most common indication for TPN was short bowel syndrome (38.5%). Eight patients had an intact colon. Urinary oxalate excretion increased on the 200-mg vitamin C dose, from 0.34 ± 0.13 to 0.44 ± 0.17 mmol/d (mean increase = 0.10 mmol/d; p = .04; 95% confidence interval 0.004 to 0.19 mmol/d). Oral intake of vitamin C and oxalate did not differ between the 2 collection periods. Conclusions: In therapeutically used doses, IV vitamin C increases urinary oxalate excretion, potentially predisposing susceptible individuals to nephrolithiasis. This factor should be considered in patients receiving home TPN.

Original languageEnglish (US)
Pages (from-to)435-438
Number of pages4
JournalJournal of Parenteral and Enteral Nutrition
Volume28
Issue number6
StatePublished - Nov 2004

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Home Parenteral Nutrition
Oxalates
parenteral feeding
oxalates
Ascorbic Acid
excretion
ascorbic acid
dosage
total parenteral nutrition
Home Total Parenteral Nutrition
renal calculi
Nephrolithiasis
Total Parenteral Nutrition
urine
Short Bowel Syndrome
Urine Specimen Collection
United States Food and Drug Administration
Nonparametric Statistics
colon
confidence interval

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Urinary oxalate excretion increases in home parenteral nutrition patients on a higher intravenous ascorbic acid dose. / Peña De La Vega, Lourdes; Lieske, John C; Milliner, Dawn; Gonyea, Janelle; Kelly, Darlene G.

In: Journal of Parenteral and Enteral Nutrition, Vol. 28, No. 6, 11.2004, p. 435-438.

Research output: Contribution to journalArticle

Peña De La Vega, Lourdes ; Lieske, John C ; Milliner, Dawn ; Gonyea, Janelle ; Kelly, Darlene G. / Urinary oxalate excretion increases in home parenteral nutrition patients on a higher intravenous ascorbic acid dose. In: Journal of Parenteral and Enteral Nutrition. 2004 ; Vol. 28, No. 6. pp. 435-438.
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abstract = "Background: Vitamin C can be metabolized to oxalate. Case reports have suggested an association between IV vitamin C and urinary oxalate excretion. Recently, the US Food and Drug Administration required the dose of vitamin C in IV multivitamin preparations to be increased from 100 mg to 200 mg/d. We compared the urinary oxalate excretion level in stable home total parenteral nutrition (TPN) patients receiving both doses of vitamin C. Methods: Each participant provided a 24-hour urine sample for oxalate determination on the vitamin C dose (100 mg/d), and again after at least 1 month on the increased vitamin C dose (200 mg/d). A 2-day diet diary was completed covering the day before and the day of the urine collection and was analyzed for oxalate and vitamin C content. Comparisons were made using Student paired t test and Wilcoxon signed rank. Results: Thirteen patients (7 males/6 females) aged 63.1 ± 12.2 years who had no history of nephrolithiasis and had received TPN for 55.9 ± 78.8 months were enrolled. The most common indication for TPN was short bowel syndrome (38.5{\%}). Eight patients had an intact colon. Urinary oxalate excretion increased on the 200-mg vitamin C dose, from 0.34 ± 0.13 to 0.44 ± 0.17 mmol/d (mean increase = 0.10 mmol/d; p = .04; 95{\%} confidence interval 0.004 to 0.19 mmol/d). Oral intake of vitamin C and oxalate did not differ between the 2 collection periods. Conclusions: In therapeutically used doses, IV vitamin C increases urinary oxalate excretion, potentially predisposing susceptible individuals to nephrolithiasis. This factor should be considered in patients receiving home TPN.",
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AU - Milliner, Dawn

AU - Gonyea, Janelle

AU - Kelly, Darlene G.

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N2 - Background: Vitamin C can be metabolized to oxalate. Case reports have suggested an association between IV vitamin C and urinary oxalate excretion. Recently, the US Food and Drug Administration required the dose of vitamin C in IV multivitamin preparations to be increased from 100 mg to 200 mg/d. We compared the urinary oxalate excretion level in stable home total parenteral nutrition (TPN) patients receiving both doses of vitamin C. Methods: Each participant provided a 24-hour urine sample for oxalate determination on the vitamin C dose (100 mg/d), and again after at least 1 month on the increased vitamin C dose (200 mg/d). A 2-day diet diary was completed covering the day before and the day of the urine collection and was analyzed for oxalate and vitamin C content. Comparisons were made using Student paired t test and Wilcoxon signed rank. Results: Thirteen patients (7 males/6 females) aged 63.1 ± 12.2 years who had no history of nephrolithiasis and had received TPN for 55.9 ± 78.8 months were enrolled. The most common indication for TPN was short bowel syndrome (38.5%). Eight patients had an intact colon. Urinary oxalate excretion increased on the 200-mg vitamin C dose, from 0.34 ± 0.13 to 0.44 ± 0.17 mmol/d (mean increase = 0.10 mmol/d; p = .04; 95% confidence interval 0.004 to 0.19 mmol/d). Oral intake of vitamin C and oxalate did not differ between the 2 collection periods. Conclusions: In therapeutically used doses, IV vitamin C increases urinary oxalate excretion, potentially predisposing susceptible individuals to nephrolithiasis. This factor should be considered in patients receiving home TPN.

AB - Background: Vitamin C can be metabolized to oxalate. Case reports have suggested an association between IV vitamin C and urinary oxalate excretion. Recently, the US Food and Drug Administration required the dose of vitamin C in IV multivitamin preparations to be increased from 100 mg to 200 mg/d. We compared the urinary oxalate excretion level in stable home total parenteral nutrition (TPN) patients receiving both doses of vitamin C. Methods: Each participant provided a 24-hour urine sample for oxalate determination on the vitamin C dose (100 mg/d), and again after at least 1 month on the increased vitamin C dose (200 mg/d). A 2-day diet diary was completed covering the day before and the day of the urine collection and was analyzed for oxalate and vitamin C content. Comparisons were made using Student paired t test and Wilcoxon signed rank. Results: Thirteen patients (7 males/6 females) aged 63.1 ± 12.2 years who had no history of nephrolithiasis and had received TPN for 55.9 ± 78.8 months were enrolled. The most common indication for TPN was short bowel syndrome (38.5%). Eight patients had an intact colon. Urinary oxalate excretion increased on the 200-mg vitamin C dose, from 0.34 ± 0.13 to 0.44 ± 0.17 mmol/d (mean increase = 0.10 mmol/d; p = .04; 95% confidence interval 0.004 to 0.19 mmol/d). Oral intake of vitamin C and oxalate did not differ between the 2 collection periods. Conclusions: In therapeutically used doses, IV vitamin C increases urinary oxalate excretion, potentially predisposing susceptible individuals to nephrolithiasis. This factor should be considered in patients receiving home TPN.

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