A patient with the small bowel syndrome is at risk for oxalate nephrolithiasis. Certain steps can be taken to reduce this risk.
Normally in the gut calcium binds with dietary oxalate to reduce absorption. In the short bowel syndrome calcium may bind with unabsorbed fatty acids and bile salts may increase oxalate absorption.
Factors affecting stone risk:
(1) amount of oxalate in diet
(2) oral calcium intake
(3) level of hydration
(4) amount of oxalate in the urine
Risk Factor
Increased Stone Risk
Decreased Stone Risk
oxalate in diet
unrestricted
low oxalate diet
oral calcium intake
low
oral calcium salt supplements given
hydration
dehydration
well-hydrated
oxaluria
high
low
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