Hyperoxaluria is a medical condition where the body retains too much oxalate. While oxalate typically is not a problem, it can be when you have primary hyperoxaluria. People with this condition have a genetic problem with their liver that prevents it from keeping oxalate in the body at manageable levels. As a result, the only way for oxalate to exit the body is through the urine, which puts extra pressure on the kidneys.
Eventually, the kidneys are unable to keep up with demand, and the oxalate starts to crystalize and bind to calcium in the body. This then leads to kidney stones, which is typically the first sign of hyperoxaluria. Because there are several different types of hyperoxaluria, it’s important to diagnose what type you have because primary hyperoxaluria is the type that stems from problems with the liver.
Once it is determined that you have primary hyperoxaluria, your doctor can start the right treatment plan. Treating hyperoxaluria is important because, in addition to kidney stones, it can eventually cause kidney failure. When this happens, you will need a kidney transplant, among other treatments. It is also important to determine what type of hyperoxaluria you have so that you know how to treat your condition.
Currently, the best way to treat primary hyperoxaluria, the type that is caused by a genetic liver mutation, is to use medications. In most cases, this means a prescription medication known as oxlumo. Oxlumo enters the body and eliminates excess oxalate, thereby reducing the amount of oxalate in the body. Oxlumo is most effective in children and young adults but may be appropriate for people of all ages.
Oxlumo is a fairly in-depth medication and may not always be necessary, depending on how severe your condition is. In these instances, prescription doses of Vitamin B-6 may be enough to reduce oxalate in the body and prevent kidney stones and kidney failure.
Other minimally invasive prescription medications include phosphates and citrate. These medications are effective at treating primary hyperoxaluria because they can either remove oxalate from the urine or keep the crystals from forming in the first place.
In addition to medications to reduce the amount of oxalate in your body, treatment for hyperoxaluria may also include lifestyle changes and modifications.
Drinking more water is a great way to help kidney stones naturally pass through your body. It can also prevent excess oxalate from building up and damaging your kidneys.
Aside from drinking more water to prevent oxalate buildup, you can also alter your diet to lessen your intake of oxalate in the first place. Oxalate is found in salt, sugar, protein, and many other foods and liquids. It may be necessary to reduce the amount of foods and drinks you consume that contain oxalate if you want to prevent unwanted buildup.
If your hyperoxaluria gets too severe and causes kidney failure, you will need to start dialysis. Dialysis will do the work of your failed kidneys until you qualify for a transplant. A kidney transplant is the only way to permanently replace your failing kidneys so that you can stop dialysis.
In addition to a kidney transplant, you may also need a liver transplant to replace your damaged liver. However, whether or not a liver transplant will permanently cure primary hyperoxaluria is unknown, and it is a highly invasive and risky treatment option.
While hyperoxaluria, specifically primary hyperoxaluria, is extremely rare, it is important to have it diagnosed and treated promptly. Therefore, if you start to have kidney stones, you should go to your doctor and have them check you for hyperoxaluria. If you have primary hyperoxaluria, you will need to make dietary and lifestyle changes and most likely start taking medications to reduce oxalate buildup.