Hiperoxaluria secundaria: causas y consecuencias de la enfermedad renal crónica

Abstract

Secondary hyperoxaluria is a metabolic disorder characterized by an increase in urinary oxalate excretion. The etiology may be due to an increase in the intake of oxalate or its precursors, a decrease in elimination at the digestive level, or an increase in renal excretion. Recently, the role of the SLC26A6 transporter in the etiopathogenesis of this disease has been discovered. It is present at both the intestinal and renal levels. Its mechanism of action is altered in situations of systemic inflammation and metabolic syndrome, which could explain the growing increase in cases of secondary hyperoxaluria in recent decades. Treatment includes hygienic dietary measures, as well as drugs aimed at reducing its absorption at the intestinal level by increasing fecal excretion. Different immunomodulatory drugs, microbiome modifiers and SGLT2 inhibitors could constitute new therapeutic targets. At present, we do not have specific treatments for secondary hyperoxaluria, so early diagnosis and measures aimed at preventing the progression of kidney failure are currently the main therapeutic tools.