Clinical and Laboratory ObservationsHyperoxaluria and Genitourinary Disorders in Children Ingesting Almond Milk Products
Section snippets
Clinical Presentation
Two girls (9 and 10 years of age) and 1 boy (3 years of age) were developmentally appropriate and healthy except for constipation in both girls. All 3 children presented with dysuria. Both girls had periumbilical or costovertebral colicky pain and intermittent gross hematuria; all 3 had persistent, isolated microscopic hematuria. One child's mother saw a “white powder” at the urethral meatus on several occasions. In addition to non-dysmorphic red blood cells, urine microscopy revealed mild
Methods
Validation of adequacy of 24-hour urine collections was ascertained by the amount of creatinine excreted per kg of lean body weight. Pre-intervention studies demonstrating hyperoxaluria were first performed at the clinical laboratory of our facility and then confirmed by a second urine collection analyzed at Litholink Corporation (Chicago, Illinois). Urinary oxalate was measured by an oxalate oxidase kit (Trinity Biotech, Bray, Ireland).6, 7 For purposes of uniformity of data comparison pre-
Discussion
We evaluated three young children presenting with hematuria and genitourinary symptoms. All 3 consumed an excessive amount of almond milk products and had marked hyperoxaluria. A tendency to low fluid intake and a hereditary predisposition to calcium-based nephrolithiasis may have been contributing factors in these children. Our children did not consume other foods with high oxalate content.14
After complying with standard dietary guidelines aimed at minimizing the risk for nephrolithiasis and
References (32)
- et al.
Almonds in the diet simultaneously improve plasma alpha-tocopherol concentrations and reduce plasma lipids
J Am Diet Assoc
(2005) - et al.
Supersaturation and stone composition in a network of dispersed treatment sites
J Urol
(1998) - et al.
Correspondence between stone composition and urine supersaturation in nephrolithiasis
Kidney Int
(1997) - et al.
Estimation of the oxalate content of foods and daily oxalate intake
Kidney Int
(2000) - et al.
Bioavailability of oxalate in foods
Urology
(1981) - et al.
A further study of oxalate in foods
J Urol
(1990) - et al.
Contribution of dietary oxalate to urinary oxalate excretion
Kidney Int
(2001) - et al.
Urinary oxalate excretion increases with body size and decreases with increasing dietary calcium intake among healthy adults
Kidney Int
(1996) - et al.
Dietary risk factors for hyperoxaluria in calcium oxalate stone formers
Kidney Int
(2003) - et al.
Potential mechanisms of marked hyperoxaluria not due to primary hyperoxaluria I or II
Kidney Int
(2002)
Effects of a low-salt diet on idiopathic hypercalciuria in calcium-oxalate stone formers: a 3-mo randomized controlled trial
Am J Clin Nutr
Factors influencing crystallization of calcium oxalate in urine: a critique
J Cryst Growth
24-hour uric acid excretion and the risk of kidney stones
Kidney Int
Urinary calcium oxalate saturation in healthy infants and children
J Urol
Assessment of oxalate absorption from almonds and black beans with and without the use of an extrinsic label
J Urol
Cited by (29)
A review of dairy food intake for improving health among black children and adolescents in the US
2024, Journal of the National Medical AssociationA review of dairy food intake for improving health for black women in the US during pregnancy, fetal development, and lactation
2024, Journal of the National Medical AssociationThe role of dairy food intake for improving health among black Americans across the life continuum: A summary of the evidence
2024, Journal of the National Medical AssociationReduction of antinutritional factors during Pinus halepensis seeds beverage processing, a focus on phytates and oxalates
2023, Journal of Food Composition and AnalysisAssociations of Oxalate Consumption and Some Individual Habits with the Risk of Kidney Stones
2023, Chinese Medical Sciences JournalPlant-Based Milk Alternatives and Risk Factors for Kidney Stones and Chronic Kidney Disease
2022, Journal of Renal NutritionCitation Excerpt :Prospective data from the Health Professionals Follow-up Study and Nurses’ Health Studies showed that increased calcium intake from dairy or nondairy dietary sources is associated with a lower risk of incident symptomatic kidney stones.4 However, there is concern that some nut-based milks may have a high oxalate content.5 This could have implications for patients with kidney stones.
The authors declare no conflicts of interest.