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Hyperoxaluria in a Model of Mini-Gastric Bypass Surgery in Rats

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Abstract

Background

Bariatric surgery is associated with hyperoxaluria hence predisposing to nephrolithiasis. The present study aimed to investigate the underlying mechanisms contributing to increased urinary oxalate in a mini-gastric bypass (MGB) surgery model in rats under different dietary conditions. The expression of intestinal oxalate transporters was also evaluated.

Methods

Male rats underwent MGB (n = 21) or Sham procedure (n = 21) and after recovery were fed a standard or high-fat diet with or without oxalate for 8 weeks. Stool and urine were collected before surgery (baseline) and at the end of protocol (final), when intestinal fragments were harvested for expression of Slc26a3 and Slc26a6 oxalate transporters.

Results

MGB groups fed with fat, irrespective of oxalate supplementation, presented steatorrhea. In MGB animals fed with fat and oxalate (Fat + Ox), final values of urinary oxalate and calcium oxalate supersaturation risk were markedly and significantly increased versus baseline or Sham animals under the same diet, as well as MGB groups under other diets. Slc26a3 was decreased in biliopancreatic limbs of MGB rats, probably reflecting a physiological adaptation to the restriction of food passage. Slc26a6 was not altered in any harvested intestinal fragment.

Conclusions

A high-fat and oxalate diet induced hyperoxaluria and elevation in calcium oxalate supersaturation risk in a MGB rat model. The presence of fat malabsorption and increased dietary oxalate absorption, but not modifications of Slc26a3 and Slc26a6 oxalate transporters, accounted for these findings, suggesting that bariatric patients may benefit from a low-fat and low-oxalate diet.

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References

  1. Park AM, Storm DW, Fulmer BR, et al. A prospective study of risk factors for nephrolithiasis after Roux-en-Y gastric bypass surgery. J Urol. 2009;182(5):2334–9.

    Article  CAS  PubMed  Google Scholar 

  2. Duffey BG, Alanee S, Pedro RN, et al. Hyperoxaluria is a long-term consequence of Roux-en-Y gastric bypass: a 2-year prospective longitudinal study. J Am Coll Surg. 2010;211(1):8–15.

    Article  PubMed  Google Scholar 

  3. Lieske JC, Mehta RA, Milliner DS, et al. Kidney stones are common after bariatric surgery. Kidney Int. 2015;87(4):839–45.

    Article  PubMed  Google Scholar 

  4. Rutledge R. Hospitalization before and after mini-gastric bypass surgery. Int J Surg. 2007;5(1):35–40.

    Article  PubMed  Google Scholar 

  5. Duffey BG, Pedro RN, Makhlouf A, et al. Roux-en-Y gastric bypass is associated with early increased risk factors for development of calcium oxalate nephrolithiasis. J Am Coll Surg. 2008;206(3):1145–53.

    Article  PubMed  Google Scholar 

  6. Curhan GC, Willett WC, Rimm EB, et al. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med. 1993;25; 328(12):833–8.

    Article  Google Scholar 

  7. Froeder L, Arasaki CH, Malheiros CA, et al. Response to dietary oxalate after bariatric surgery. Clin J Am Soc Nephrol. 2012;7(12):2033–40.

  8. Kumar R, Lieske JC, Collazo-Clavell ML, et al. Fat malabsorption and increased intestinal oxalate absorption are common after Roux-en-Y gastric bypass surgery. Surgery. 2011;149(5):654–61.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Canales BK, Ellen J, Khan SR, et al. Steatorrhea and hyperoxaluria occur after gastric bypass surgery in obese rats regardless of dietary fat or oxalate. J Urol. 2013;190(3):1102–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Ferraz RR, Tiselius HG, Heilberg IP. Fat malabsorption induced by gastrointestinal lipase inhibitor leads to an increase in urinary oxalate excretion. Kidney Int. 2004;66(2):676–82.

    Article  CAS  PubMed  Google Scholar 

  11. Hatch M, Canales BK. The mechanistic basis of hyperoxaluria following gastric bypass in obese rats. Urolithiasis. 2015;44(3):221–30.

  12. Robijn S, Hoppe B, Vervaet BA, et al. Hyperoxaluria: a gut-kidney axis? Kidney Int. 2011;80(11):1146–58.

  13. Freel RW, Whittamore JM, Hatch M. Transcellular oxalate and Cl−absorption in mouse intestine is mediated by the DRA anion exchanger Slc26a3, and DRA deletion decreases urinary oxalate. Am J Physiol Gastrointest Liver Physiol. 2013;305(7):G520-7.

  14. Freel RW, Hatch M, Green M, et al. Ileal oxalate absorption and urinary oxalate excretion are enhanced in Slc26a6 null mice. Am J Physiol Gastrointest Liver Physiol. 2006;290(4):G719–28.

    Article  CAS  PubMed  Google Scholar 

  15. Stenstrom B, Furnes MW, Tommeras K, et al. Mechanism of gastric bypass-induced body weight loss: one-year follow-up after micro-gastric bypass in rats. J Gastrointest Surg. 2006;10(10):1384–91.

    Article  PubMed  Google Scholar 

  16. Cavin JB, Voitellier E, Cluzeaud F, et al. Malabsorption and intestinal adaptation after one anastomosis gastric bypass compared to Roux-en-Y gastric bypass in rats. Am J Physiol Gastrointest Liver Physiol. 2016;311(3):G492-500.

  17. Ferraz RR, Baxmann AC, Ferreira LG, et al. Preservation of urine samples for metabolic evaluation of stone-forming patients. Urol Res. 2006;34(5):329–37.

    Article  PubMed  Google Scholar 

  18. Tiselius HG, Ferraz RR, Heilberg IP. An approximate estimate of the ion-activity product of calcium oxalate in rat urine. Urol Res. 2003;31(6):410–3.

    Article  CAS  PubMed  Google Scholar 

  19. Worcester E, Evan A, Bledsoe S, et al. Pathophysiological correlates of two unique renal tubule lesions in rats with intestinal resection. Am J Physiol Renal Physiol. 2006;291(5):F1061–9.

    Article  CAS  PubMed  Google Scholar 

  20. Worcester EM, Chuang M, Laven B, et al. A new animal model of hyperoxaluria and nephrolithiasis in rats with small bowel resection. Urol Res. 2005;33(5):380–2.

    Article  PubMed  Google Scholar 

  21. O’Connor RC, Worcester EM, Evan AP, et al. Nephrolithiasis and nephrocalcinosis in rats with small bowel resection. Urol Res. 2005;33(2):105–15.

    Article  PubMed  Google Scholar 

  22. Bueter M, Lowenstein C, Olbers T, et al. Gastric bypass increases energy expenditure in rats. Gastroenterology. 2010;138(5):1845–53.

    Article  PubMed  Google Scholar 

  23. Stylopoulos N, Hoppin AG, et al. Roux-en-Y gastric bypass enhances energy expenditure and extends lifespan in diet-induced obese rats. Obesity (Silver Spring). 2009;17(10):1839–47.

    Article  Google Scholar 

  24. Furnes MW, Tommeras K, Arum CJ, et al. Gastric bypass surgery causes body weight loss without reducing food intake in rats. Obes Surg. 2008;18(4):415–22.

    Article  PubMed  Google Scholar 

  25. Odstrcil EA, Martinez JG, Santa Ana CA, et al. The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass. Am J Clin Nutr. 2010;92(4):704–13.

    Article  CAS  PubMed  Google Scholar 

  26. Sinha MK, Collazo-Clavell ML, Rule A, et al. Hyperoxaluric nephrolithiasis is a complication of Roux-en-Y gastric bypass surgery. Kidney Int. 2007;72(1):100–7.

    Article  CAS  PubMed  Google Scholar 

  27. Bueter M, Ashrafian H, Frankel AH, et al. Sodium and water handling after gastric bypass surgery in a rat model. Surg Obes Relat Dis. 2011;7(1):68–73.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by grant from Fundação de Amparo à Pesquisa do Estado de São Paulo—FAPESP (Grant 2010/52180-4). Portions of this study were presented at the 51st ERA-EDTA Congress, Amsterdam, Netherlands, 2014, and at the Annual Meeting of the American Society of Nephrology, Philadelphia, USA, 2014.

We thank Emanoel Barreto Cabral and Silvia Regina Moreira for their technical assistance.

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Authors and Affiliations

  1. Nephrology Division, Universidade Federal de São Paulo, R.Botucatu 740, São Paulo, SP, 04023-900, Brazil

    Milene S. Ormanji, Fernando Korkes, Renata Meca, Crysthiane S.R.A. Ishiy, Gustavo H.C. Finotti, Renato R.N. Ferraz & Ita P. Heilberg

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  1. Milene S. Ormanji
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  2. Fernando Korkes
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  3. Renata Meca
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  4. Crysthiane S.R.A. Ishiy
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  5. Gustavo H.C. Finotti
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  6. Renato R.N. Ferraz
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  7. Ita P. Heilberg
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Corresponding author

Correspondence to Ita P. Heilberg.

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Funding

This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo—FAPESP (Grant 2010/52180-4).

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Animal Rights

All applicable institutional and/or national guidelines for the care and use of animals were followed.

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Ormanji, M.S., Korkes, F., Meca, R. et al. Hyperoxaluria in a Model of Mini-Gastric Bypass Surgery in Rats. OBES SURG 27, 3202–3208 (2017). https://doi.org/10.1007/s11695-017-2725-3

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