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Enteric Hyperoxaluria — RACP Adult Medicine MCQ

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HardNephrologyEnteric HyperoxaluriaRACP Adult Medicine

A patient with recurrent calcium-oxalate stones after ileal resection has hyperoxaluria, low urine volume and normal urine calcium. Which dietary prescription best addresses enteric hyperoxaluria?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Use normal meal-time calcium, lower dietary oxalate and increase fluid intake

Explanation lettering: D = shown as A · A = shown as B · E = shown as D · B = shown as E

C is correct because meal-time calcium binds intestinal oxalate, while reducing excessive oxalate and malabsorbed fat and increasing urine volume lowers calcium-oxalate supersaturation. D increases free oxalate absorption. E misses the required temporal binding to dietary oxalate. A can increase oxalate production. B raises, rather than lowers, urinary supersaturation. Treatment is individualised with dietetic input and repeat 24-hour urine assessment.

Reference: Australian CARI Guidelines, Kidney stones: https://www.cariguidelines.org/guidelines/kidney-stones/; Australian CARI Guidelines, Nutrition therapy for prevention of kidney stones: https://www.cariguidelines.org/guidelines/kidney-stones/nutrition-therapy-for-the-prevention-of-kidney-stones/