PRIMARY HYPEROXALURIA

Dietary and metabolic studies carried out on a patient with primary hyperoxaluria are reported. There was no appreciable change in the urinary excretion of oxalate when he was given a diet low in oxalate, or ascorbic acid, magnesium or riboflavin. A diet high in protein and low in carbohydrate was associated with increased excretion of oxalate, whereas increased catabolism of protein induced by cortisone and the postoperative state did not appreciably change the urinary excretion of oxalate. Evidence that the source of increased accumulation of oxalate might be related to the glycine-glyoxylate-oxalate pathway is the observation that the increased urinary excretion of oxalate in the mother was slightly depressed by the administration of sodium benzoate. Glycine (10 gm) did not cause an appreciable increase in oxalate in the urine but may have been associated with formation of bladder stones in the patient. The ratio of oxalate to nitrogen in the urine remained relatively constant during wide fluctuations in excretion of nitrogen.