Is hyperoxaluria in a porcine model of Roux-en-Y gastric bypass (RYGB) associated with exocrine pancreatic insufficiency?
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 5
Abstract
Introduction. Exocrine pancreatic insufficiency (EPI) is always provided by efficient Roux-en-Y gastric bypass (RYGB) surgery. In the same time, one of the complications of EPI as well as bariatric surgery is oxalate nephropathy.Aim. The aim of the study was to develop a porcine model of enteric hyperoxaluria after RYGB to investigate its adverse effects in humans.Material and methods. A total of 11 pigs (n = 7 Roux-en-Y gastric bypass surgery and n = 4 intact – controls) were used in the study. Pigs were fed either regular pig feed (RF), a low calcium pig feed or human type food. RF was enriched with 0.5 or 1% potassium oxalate (KOx).Results. Following surgery, pigs displayed complete growth arrest for up to 6 weeks, after which they began to grow slightly. Growth of intact control pigs was normal. During the 51 days following surgery (P1 period), daily urinary oxalate excretion levels did not differ between bariatric and control pigs and was approximately 20 ± 10.6 mg/24 h at day 51. Inclusion of 0.5% (P2 period) and 1% (P3 period) KOx to the regular pig feed, increased urinary oxalate excretion both in bariatric and intact control pigs (43.7 ± 32.1 mg/24 h vs. 23.2 ± 18.4 mg/24 h and 51.4 ± 20.5 mg/24 h vs. 48.7 ± 39.2 mg/24 h, respectively) but significant differences compared to P1 period were found only after the 1% inclusion level (P < 0.05). Oxalate excretion in RYGB pigs remained at relatively higher levels after KOx removal from the diet. Pig fed low calcium diet showed higher levels of urinary oxalate excretion as compared to pigs fed regular diet. Surprisingly total calcium depletion from urine was found in pigs after RYGB.Conclusions. Dietary oxalate governs the development of enteric hyperoxaluria in bariatric pigs, which are more sensitive to it than intact control pigs. The pig model described in the present study could be a sensitive tool used to highlight the mechanisms of enteric hyperoxaluria following RYGB in humans. The interaction between exocrine pancreatic insufficiency and bariatric surgery should be also more profoundly explored.
Authors and Affiliations
Stanisław Winiarczyk, Jose L. Valverde Piedra, Sylwia Szymańczyk, Katarzyna Szwiec, Piotr Chrościcki, Jerzy Mackiewicz, Mateusz Winiarczyk, Dagmara Wyłupek, Łukasz Adaszek, Kamil Torres, Paulina Świeboda, Olena Prykhodko, Olexandr Fedkiv, Blanka Majda, Rafał Filip, Kateryna Goncharova, Stefan G. Pierzynowski
Keywords
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