Hyperoxaluria

A health condition in which increased oxalate levels in the urine occurs is called hyperoxaluria. Oxalate is found in some foods but it also is produced naturally by the body. High oxalate amounts in the urine can cause serious health problems.

This condition usually occurs due to a gene mutation, an intestinal disease, or eating many foods rich in oxalate. With early diagnosis and treatment, you can prevent complications and maintain your kidneys healthy.

However, when kidneys do not work properly it may lead to oxalosis. It usually happens in people with bowel-related causes of hyperoxaluria. High oxalate levels may collect in the blood and build up in the bones, blood vessels, and organs.

Symptoms

Commonly, the first hyperoxaluria symptom is a kidney stone. Check below other symptoms:

  • Frequent urination
  • Cannot urinate or pee a small amount only
  • Fever
  • Stomach upset
  • Chills
  • Vomiting
  • Urine color changes such as pink, red, or brown due to blood
  • Pain that occurs in the back, groin, or abdomen

Kidney stones usually do not happen in children and if they occur, are more likely due to a health problem such as hyperoxaluria. If you experience any of the previous symptoms, do not hesitate to see a doctor.

Causes

This condition occurs due to an increased oxalate level that builds up in the urine. However, there are different hyperoxaluria types. For example:

Primary Hyperoxaluria

This type occurs quite rarely and it usually runs in families. This inherited disorder causes the liver to make a reduced protein that helps to prevent high oxalate levels or it does not work correctly. Extra oxalates go away from the body through the kidneys in the urine. Oxalates may combine with calcium to make kidney crystals or stones. Therefore, damage to the kidneys may occur, which prevents them from working well.

In most cases, people with primary hyperoxaluria develop kidney stones early and begin to experience symptoms from childhood through age 20. In such cases, kidneys stop working well by early to middle adulthood. While kidney failure may occur even in babies, others with primary hyperoxaluria may never develop this condition.

Enteric Hyperoxaluria

Sometimes, people experience hyperoxaluria due to certain intestine problems that cause the body to absorb more oxalate from foods. Thus, it leads to high oxalate levels. Certain intestine conditions that commonly cause enteric hyperoxaluria include Crohn’s disease, short bowel syndrome, and others.

However, certain health conditions may cause the small bowel to absorb fats from food quite hard. When it happens, the intestine is more available to absorb oxalates. In most cases, oxalates combine with calcium in the bowel and go away from the body through stools. In any case, if an increased fat amounts happen in the intestine calcium binds to the fat instead of oxalates. As a result, oxalates are absorbed in the bloodstream and thereafter are filtered by the kidneys.

Furthermore, there is a surgery that also may lead to increased hyperoxaluria risk and it is called Roux-en-Y gastric bypass surgery.

Hyperoxaluria Linked with Foods High in Oxalates

The risk of this health problem also increases if you are eating large amounts of foods high in oxalates. For example nuts, chocolate, brewed tea, spinach, potatoes, beets, and rhubarb. Healthcare professionals usually recommend limiting foods high in oxalates for people either with enteric or primary hyperoxaluria.

What Are The Potential Complications of Hyperoxaluria?

If you ignore the symptoms and do not treat this health problem, it may lead to damage to the kidneys and their failure. Kidney failure occurs when they stop working well. Sometimes, kidney failure symptoms are the first sign of hyperoxaluria. Check below some kidney failure symptoms:

  • Lack of appetite
  • Stomach upset
  • Vomiting
  • Tiredness
  • Reduced urination
  • Swelling of the feet and hands
  • Anemia (reduced red blood cell count)

People with primary or enteric hyperoxaluria usually experience oxalosis and kidneys stop working completely. As a result, the body cannot remove oxalates, which leads to their buildup. Commonly, oxalates build up in the blood first and thereafter, in the bones, skin, muscles, blood vessels, eyes, heart, and other body tissues and organs. Furthermore, oxalosis can cause many other health problems along with kidney disease. For example:

  • Bone disease
  • Anemia
  • Skin ulcers
  • Heart and eye disease
  • Delays in growth and development (in children)

Diagnosis

Usually, doctors to diagnose this condition perform a physical examination and perform some tests. They may also ask you some questions about symptoms and medical history. Check below some tests often involved in the hyperoxaluria diagnosis:

  • Blood and urine tests – These tests are done to measure oxalate levels and check kidney function.
  • Stone analysis – During this procedure doctors analyze kidney stones of what they are made of.
  • Kidney imaging tests – These include X-ray, CT (computerized tomography) scans, and ultrasound. Kidney imaging tests help doctors get images of the kidneys, which help to identify kidney stones or calcium oxalate buildup.

Sometimes, people need more tests to confirm the condition and determine how far the disease goes. For example:

  • DNA testing helps to identify gene changes that lead to primary hyperoxaluria.
  • Kidney biopsy is used to check for oxalate buildup
  • Echocardiogram is an imaging test used to check for oxalate buildup in the heart
  • Eye examinations are performed by doctors to check for oxalate deposits in the eyes
  • Bone marrow and liver biopsy are used to check for oxalate buildup in the bones and protein levels (liver enzymes).

Treatment

The treatment usually is different among people because it depends on the hyperoxaluria type you experience and its severity. Check below some treatment options usually recommended by doctors for people with hyperoxaluria:

Decreasing Oxalate

  • Medications – Doctors usually prescribe Lumasiran or Pyridoxine (prescription doses of vitamin B-6) to reduce oxalate levels in children and adults with primary hyperoxaluria. They also may advise phosphates and citrate made by a pharmacy to prevent calcium oxalate crystals from forming.For people with enteric hyperoxaluria, physicians usually recommend Thiazide diuretics and calcium supplements to be taken with a meal. Therefore, it may be easier for oxalate to combine with calcium in the bowel and go outside the body through stool.
  • Drink plenty of fluids – Physicians frequently recommend drinking plenty of water, especially if your kidneys still working properly. It may help to prevent oxalate buildup.
  • Dietary changes – Generally, you should pay attention to the foods you are eating if you experience enteric hyperoxaluria. Therefore, physicians may recommend limiting foods high in oxalates, salt, sugar, and animal protein. However, dietary changes usually do not help people with primary hyperoxaluria.

Dialysis and Transplants

Some people require a treatment called dialysis, which helps kidneys work better but it cannot reduce oxalate production. This treatment option is usually recommended for people whose kidneys do not work at all. Thus, the only treatment that may cure primary hyperoxaluria is kidney and liver transplants.

Frequently Asked Questions

What are the main symptoms of high oxalates in the body?

  • Urinary, muscle, intestinal, or eye pain
  • Genital irritation
  • Headaches
  • Sleep disturbances (insomnia)
  • Weakness
  • Atherosclerosis
  • Prostatitis
  • Mood disorders
  • Anxiety

If you experience any of the previous symptoms, you may have hyperoxaluria. However, you should see a doctor to confirm the condition because there are other common diseases that cause these symptoms.

How to prevent oxalate buildup in the body?

Limiting foods high in oxalates and drinking a lot of water can help oxalates get away from the body.

What happens if hyperoxaluria is not treated?

People who do not get treatment for hyperoxaluria may experience some complications. These include sharp pain in the abdominal or groin area, chronic kidney disease, urosepsis, acute kidney injury, renal obstruction, and even death. If you have additional questions, ask your healthcare professional.

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