In individuals with chronic kidney disease (CKD) stages 2 to 4, higher 24-hour urinary oxalate excretion may be a risk factor for CKD progression and end-stage renal disease (ESRD), a new study found. Researchers assessed 3,123 individuals with CKD stages 2 to 4 CKD to determine whether urinary oxalate excretion is a risk factor for more rapid progression of CKD toward kidney failure. The primary outcomes were a 50% decline in estimated glomerular filtration rate (eGFR) and ESRD. They found:

• During 22,318 person-years of follow-up, 752 individuals reached ESRD, and 940 reached the composite end point of ESRD or 50% decline in eGFR (CKD progression).

• Higher oxalate excretion was independently associated with greater risks of both CKD progression and ESRD.

• Higher urinary excretion of oxalate was associated with a 37% greater adjusted risk of future end-stage kidney disease.