A recent report (Ellis D, Lieb J. J Pediatr 2015; 167:1155-8) highlights the high content of oxalate in almond milk products which led to hyperoxaluria and hematuria in three children.

Key points:

•  “A tendency to low fluid intake and a hereditary predisposition to calcium-based nephrolithiasis may have been contributing factors.”
• “Mammals lack oxalic decarboxylase and other enzymes that can degrade oxalic acid…oxalate homeostasis depends on” ..1) dietary intake, 2) endogenous synthesis of oxalate, 3) GI flora degradation and limiting of absorption,  and 4) renal processing/excretion of oxalate

My take: In patients with oxalate kidney stones or microscopic hematuria, limiting almond milk and increasing fluid intake would be beneficial.

Gabi