High Oxalate Leads to Increased Cardiovascular Risks in Diabetic Patients on Hemodialysis


Dr. Umair H. | July 25, 2021

A new study suggests that elevated levels of "serum oxalate" in patients with type 2 diabetes on hemodialysis (HD) increase their risk for sudden cardiac death and other serious cardiovascular events.

This randomized German Diabetes Dialysis Study included 1255 European patients on HD who had type 2 diabetes mellitus. The median follow-up duration was 04 years.

Patients in the highest oxalate quartile (59.7 µM or higher) had a 40% increased risk for cardiac death, nonfatal myocardial infarction, and fatal or nonfatal stroke compared with patients in the lowest oxalate quartile (29.6 µM or less). Patients in the highest oxalate quartile (59.7 µM or higher) had a 62% increased risk for sudden cardiac death compared with patients in the lowest oxalate quartile (29.6 µM or less). Patients in the highest quartile had a 23% increased risk for all-cause mortality when compared to the lowest quartile. These findings were reported in the Journal of the American Society of Nephrology.

The findings are consistent with a large body of evidence suggesting that oxalate is a "uremic toxin." Oxalate lowering strategies in dialysis patients are needed to test the cause-effect nature of these findings and find a novel treatment paradigm.

Source: Ffau A, Ermer T, Coca S, et al. High oxalate concentrations correlate with increased risk for sudden cardiac death in dialysis patients. J Am Soc Nephrol. Published online July 19, 2021. doi:10.1681/ASN.2020121793

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