Reviewed January 2008
What is primary hyperoxaluria?
Primary hyperoxaluria is a rare condition characterized by the overproduction of a substance called oxalate (also called oxalic acid). In the kidneys, the excess oxalate combines with calcium to form calcium oxalate, a hard compound that is the main component of kidney stones. Deposits of calcium oxalate can lead to kidney damage, kidney failure, and injury to other organs.
Primary hyperoxaluria is caused by the shortage (deficiency) of an enzyme that normally prevents the buildup of oxalate. There are two types of primary hyperoxaluria, distinguished by the enzyme that is deficient. People with type 1 primary hyperoxaluria have a shortage of a liver enzyme called alanine-glyoxylate aminotransferase (AGXT). Type 2 primary hyperoxaluria is characterized by a shortage of an enzyme called glyoxylate reductase/hydroxypyruvate reductase (GRHPR).
How common is primary hyperoxaluria?
Type 1 primary hyperoxaluria is estimated to occur in 1 to 3 per million people; it is more common in some Mediterranean countries, such as Tunisia. Although the incidence of type 2 primary hyperoxaluria is unknown, it is less common than type 1.
What genes are related to primary hyperoxaluria?
Mutations in the AGXT and GRHPR genes cause primary hyperoxaluria.
The breakdown and processing of certain sugars and protein building blocks (amino acids) produces a substance called glyoxylate. Normally, glyoxylate is converted to the amino acid glycine or to a compound called glycolate through the action of two enzymes, alanine-glyoxylate aminotransferase and glyoxylate reductase/hydroxypyruvate reductase, respectively. Mutations in the AGXT or GRHPR gene cause a shortage of these enzymes, which prevents the conversion of glyoxylate to glycine or glycolate. As levels of glyoxylate build up, it is converted to oxalate. Oxalate combines with calcium to form calcium oxalate deposits, which can damage the kidneys and other organs.
How do people inherit primary hyperoxaluria?
This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.
Where can I find information about treatment for primary hyperoxaluria?
You may find information on treatment or management of primary hyperoxaluria or some of its symptoms in the links below, particularly the links for
Gene Reviews, Educational resources, and Patient support.
Where can I find additional information about primary hyperoxaluria?
You may find the following resources about primary hyperoxaluria helpful. These materials are written for the general public.
- MedlinePlus - Health information
- Health Topic: Kidney Diseases (http://www.nlm.nih.gov/medlineplus/kidneydiseases.html)
- Health Topic: Metabolic Disorders (http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html)
- Additional NIH Resources - National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases: Kidney Stones (http://kidney.niddk.nih.gov/kudiseases/pubs/stones_ez/index.htm)
- National Institute of Diabetes and Digestive and Kidney Diseases: Your Kidneys and How They Work (http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm)
- Educational resources - Information pages
- Ask the Geneticist: Inheritance of Primary Hyperoxaluria (http://www.genetics.emory.edu/ask/question.php?question_id=1136)
- Madisons Foundation (http://www.madisonsfoundation.org/index.php/component/option,com_mpower/diseaseID,419/)
- Mayo Clinic: Division of Nephrology and Hypertension (http://mayoresearch.mayo.edu/mayo/research/nephrology/hyperoxaluria.cfm)
- Nemours Foundation: Kidneys and Urinary Tract (http://kidshealth.org/parent/general/body_basics/kidneys_urinary.html)
- Orphanet (http://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=EN&Expert=416)
- Patient support - For patients and families
- Children Living with Inherited Metabolic Diseases (CLIMB) (http://www.climb.org.uk)
- Family Village (http://www.familyvillage.wisc.edu/lib_oh.htm)
- International Registry for Hereditary Calcium Stone Diseases (http://mayoresearch.mayo.edu/mayo/research/nephrology/registry.cfm)
- Mayo Clinic Hyperoxaluria Center (http://www.mayoclinic.org/nephrology-rst/hyperoxaluriacenter.html)
- National Organization for Rare Disorders (http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Hyperoxaluria,+Primary+(Type+I))
- The Oxalosis and Hyperoxaluria Foundation (http://www.ohf.org/about_disease.html)
You may also be interested in these resources, which are designed for healthcare professionals and researchers.
- Gene Reviews - Clinical summary
- Gene Review: Primary Hyperoxaluria, Type 1 (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=ph1)
- Gene Review: Primary Hyperoxaluria, Type 2 (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=ph2)
- Gene Tests - DNA tests ordered by healthcare professionals
- Gene Tests: Hyperoxaluria, Primary, Type 1 (http://www.genetests.org/query?testid=64481)
- Gene Tests: Hyperoxaluria, Primary, Type 2 (http://www.genetests.org/query?testid=118459)
- ClinicalTrials.gov - Linking patients to medical research (http://clinicaltrials.gov/search/condition=%22primary+hyperoxaluria%22)
- PubMed - Recent literature (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=PubMed&term=(Hyperoxaluria,+Primary[MAJR])+AND+(hyperoxaluria,+primary[ALL])+AND+english[la]+AND+human[mh]&orig_db=PubMed&filters=ON&pmfilter_EDatLimit=1080+Days)
- OMIM - Genetic disorder catalog
- OMIM topic: Hyperoxaluria, primary, type I (http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=259900)
- OMIM topic: Hyperoxaluria, primary, type II (http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=260000)
What other names do people use for primary hyperoxaluria?
- D-glycerate dehydrogenase deficiency
- glyceric aciduria
- glycolic aciduria
- hepatic AGT deficiency
- HP1
- HP2
- Hyperoxaluria, Primary
- Oxalosis
- Oxaluria, Primary
- peroxisomal alanine:glyoxylate aminotransferase deficiency
See How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.
What if I still have specific questions about primary hyperoxaluria?
- See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.
- Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).
- Submit your question to Ask the Geneticist (http://www.askthegen.org/).
What glossary definitions help with understanding primary hyperoxaluria?
acids ;
aciduria ;
amino acid ;
autosomal ;
autosomal recessive ;
calcium ;
cell ;
compound ;
deficiency ;
dehydrogenase ;
enzyme ;
gene ;
glycine ;
hepatic ;
incidence ;
injury ;
kidney ;
kidney stones ;
mutation ;
protein ;
recessive ;
reductases ;
sign ;
stone ;
symptom
You may find definitions for these and many other terms in the Genetics Home Reference
Glossary (http://ghr.nlm.nih.gov/glossary).
References
- Cramer SD, Ferree PM, Lin K, Milliner DS, Holmes RP. The gene encoding hydroxypyruvate reductase (GRHPR) is mutated in patients with primary hyperoxaluria type II. Hum Mol Genet. 1999 Oct;8(11):2063-9. Erratum in: Hum Mol Genet 1999 Dec;8(13):2574. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=Abstract&list_uids=10484776)
- Cregeen DP, Williams EL, Hulton S, Rumsby G. Molecular analysis of the glyoxylate reductase (GRHPR) gene and description of mutations underlying primary hyperoxaluria type 2. Hum Mutat. 2003 Dec;22(6):497. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=Abstract&list_uids=14635115)
- Danpure CJ. Molecular aetiology of primary hyperoxaluria type 1. Nephron Exp Nephrol. 2004;98(2):e39-44. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=Abstract&list_uids=15499210)
- Gene Review: Primary Hyperoxaluria, Type 1 (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=ph1)
- Leumann E, Hoppe B. The primary hyperoxalurias. J Am Soc Nephrol. 2001 Sep;12(9):1986-93. Review. No abstract available. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=Abstract&list_uids=11518794)
- Pirulli D, Marangella M, Amoroso A. Primary hyperoxaluria: genotype-phenotype correlation. J Nephrol. 2003 Mar-Apr;16(2):297-309. Review. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=Abstract&list_uids=12768081)
The resources on this site should not be used as a substitute for
professional medical care or advice. Users seeking information about
a personal genetic disease, syndrome, or condition should consult with a qualified
healthcare professional.
See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.
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