Hyperoxaluria correlates with fat malabsorption in patients with sprue.

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Abstract
The effect of fat malabsorption on the absorption and renal excretion of dietary oxalate was studied in 4 patients with sprue and in 2 patients with dermatitis herpetiformis and sprue-like jejunal histology. Hyperoxaluria was present in all patients with sprue when fat malabsorption was severe. Urinary oxalate excretion decreased in 2 of the 3 patients with celiac sprue when their fat malabsorption had improved after 3 mo. of dietary gluten restriction. Neither patient with dermatitis herpetiformis and sprue had steatorrhea. In these patients, urinary oxalate excretion was always within normal limits. A significant positive linear relationship (y = 28.25 + 4.84x; r = 0.82; P < 0.01) was demonstrated between fecal fat and urinary oxalate excretion. Severe malabsorption of dietary fat plays a primary causative role in enteric hyperoxaluria.