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Increased Rates of Supplement-Associated Oxalate Nephropathy During COVID-19 Pandemic

Summary

During the COVID-19 pandemic, more people took dietary supplements and high-dose vitamin C for health reasons. However, this study found that excessive supplement intake led to a significant increase in a kidney disease called oxalate nephropathy, where calcium oxalate crystals damage the kidneys. The good news is that when patients stopped taking these harmful supplements, their kidney function often improved, emphasizing the importance of careful supplement use.

Background

Secondary oxalate nephropathy results from calcium oxalate crystal deposition in kidney tubules, caused by hyperoxaluria from enteric dysfunction or excessive oxalate intake. During the COVID-19 pandemic, there was a dramatic increase in supplement and vitamin C sales, prompting investigation of whether supplement-associated oxalate nephropathy increased during this period.

Objective

To determine if there was an increase in supplement-associated oxalate nephropathy during the COVID-19 pandemic compared to the pre-pandemic period and to characterize the etiology, clinical features, and kidney outcomes of these cases.

Results

Of 35 patients with oxalate nephropathy, supplement-associated cases comprised 44% during 2020-2022 versus 0% in 2018-2019 (P=0.002). Enteric dysfunction-associated cases decreased from 42% to 13% (P=0.053). Eight of 9 patients with ingestion-associated oxalate nephropathy who discontinued the offending substance experienced improvement in kidney function at median 10-month follow-up.

Conclusion

There was a significant shift toward supplements rather than enteric dysfunction as the leading cause of secondary oxalate nephropathy during COVID-19. Kidney outcomes improve when the causative agent is identified and removed, supporting the use of kidney biopsy in unexplained kidney dysfunction.
  • Published in:Kidney International Reports,
  • Study Type:Retrospective Cohort Study,
  • Source: PMID: 36120391, DOI: 10.1016/j.ekir.2022.09.002
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