STUDIES ON SOME POSSIBLE BIOCHEMICAL TREATMENTS OF PRIMARY HYPEROXALURIA

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  • 1 January 1979
    • journal article
    • research article
    • Vol. 48  (190) , 259-272
Abstract
The effects of some putative inhibitors of oxalate production on urinary oxalate excretion were investigated in the cynomolgus monkey [Macaca fascicularis] and in patients with Type 1 primary hyperoxaluria (hyperoxaluria with glycollic aciduria). Sodium-1-hydroxybutan-sulfonate, D,L-phenylacetate, succinimide and isocarboxazide did not reduce the urinary oxalate excretion in the monkeys. Pyridoxine reduced the excretion of oxalate and glycollate in some patients and its therapeutic use was documented over a 5 yr period. Succinimide, which was used by other workers for the treatment of non-hyperoxaluric stone formers, did not decrease the excretion of either oxalate or glycollate in 3 patients in whom it was tried. It did not change the inhibitory activity of the urine with respect to the growth and aggregation of calcium oxalate crystals in any of the 3 patients and it did not have any consistent effect on the excretion of calcium oxalate crystals in the 1 patient who had detectable crystaluria before treatment. Several metabolites of succinimide were identified in the urine of patients taking the drug. These include 2,3-dehydrosuccinamic, 2-hydroxysuccinamic and 3-hydroxysuccinamic acids. Isocarboxazide, cholestyramine and thiamine did not affect the urinary oxalate excretion in the patients. The significance of these observations from the viewpoint of the treatment of primary hyperoxaluria is discussed.