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Oxalate is a dicarboxylic acid, an end product of glyoxalate and glycerate metabolism that is excreted in the urine where it is a common component of kidney stones (up to 85%). Hyperoxaluria can be either genetic (eg, primary hyperoxaluria) or acquired/secondary (eg, enteric hyperoxaluria), and can lead to nephrocalcinosis and renal failure. Monitoring the adequacy of oxalate removal during hemodialysis can be useful in the management of patients with hyperoxaluria and renal failure, particularly following transplantation.
Determining the amount of oxalate removed during a dialysis session
Individualizing the dialysis prescription of hyperoxaluric patients
A steady decrease in oxalate signal is expected through dialysis procedure.
Signals below 2 mcM should be considered ideal conditions.
Total oxalate removed during a dialysis session can be estimated by multiplying the concentration of oxalate in the dialysate by the oxalate flow rate for each time period that the oxalate is measured.
Proper specimen processing and acidification are essential to obtain a quality result and avoid nonenzymatic generation of oxalate from ascorbate.
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