The primary goals of the management of PH1 are to lower both plasma oxalate and plasma calcium oxalate saturation. To that end, conservative measures should be initiated immediately upon diagnosis. Serial determinations of the crystalluria score and use of software to calculate calcium oxalate supersaturation can help assess the effects of conservative treatment initiatives.
Ascorbic acid supplementation is not recommended because it is a precursor of oxalate.
Calcium oxalate crystallization inhibitors (eg, potassium or sodium citrate, 100 mg/kg/d to 150 mg/kg/d in three to four divided doses) or neutral phosphate is compulsory in order to reduce calcium absorption and thus calciuria and to inhibit the growth and accumulation of calcium oxalate crystals.
Calcium restriction is not recommended in the management of PH1. Calcium is known to bind oxalate in the gut, making it unavailable for absorption and subsequent excretion. Therefore, decreasing calcium intake will increase oxalate absorption.
Learn more about the management of PH1.
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Cite this: Bradley Schwartz. Fast Five Quiz: Primary Hyperoxaluria Type 1 Management - Medscape - Mar 04, 2022.