Hyperoxaluria occurs when a patient has too much oxalate in their urine. Oxalate is a natural chemical that is made by the body, but it can also be found in some foods. There are various reasons that this condition can occur, and patients might suffer long-term kidney damage related to the condition if treatment is not begun quickly after symptoms start.
The most common first symptom of this condition is kidney stones. Kidney stones cause the following symptoms:
While this is the first early warning symptom of this condition, kidney damage can follow these early-onset symptoms. Kidney failure can cause bone pain and muscle cramps, fatigue, itchy and dry skin, headaches, insomnia, recurring UTIs, and poor appetite.
There are different types of Hyperoxaluria that patients can experience.
This is the inherited version of the condition. In this condition, the liver is not making enough of a specific protein that halts the production of oxalate. When the liver is not producing the necessary oxalate, crystals can form in the urine, leading to kidney stones. In primary Hyperoxaluria, patients will suffer from kidney damage early in their life. Primary Hyperoxaluria causes kidney failure in those under 20, and even babies can experience kidney failure with this kind of Hyperoxaluria.
Intestine problems can lead to the body absorbing too much oxalate from foods. This means that the oxalate increases in the urine. Crohn’s Disease is an example of the kind of intestine problem that can lead to enteric hyperoxaluria. When intestine health issues lead to oxalate absorption problems, this can cause problems with kidney function.
When you eat many foods every day that have oxalate in them, you raise your risk for Hyperoxaluria and kidney stones. The foods that can lead to this issue are chocolate, brewed tea, spinach, beets, potatoes, rhubarb, and nuts.
The risk factors for Hyperoxaluria are:
Your doctor will start with a full physical examination. They will also want to take a diet history to see if your condition might be impacted by the foods that you are eating. Urine tests are often done to diagnose crystals in the urine that might lead to kidney or bladder stones. Blood tests can also be done to look at the level of oxalate in the blood.
CT scans are often done to look at the kidneys and the urinary tract and to check for existing kidney stones. Bone marrow tests might also be needed to verify the levels of oxalate in the bones and the kidneys. An echocardiogram can be done to check heart tissue health and eye exams are usually performed to verify that there are no oxalate deposits in the eyes.
This condition is treated by lowering the amount of oxalate in the body. This can be done via medications such as vitamin B-6 or through thiazide diuretics. These medications change the pH in the body and help manage symptoms of Hyperoxaluria. Patients will be directed to drink more fluids and to change their diet to avoid foods that are high in oxalate.
Kidney stones might need to be treated with the use of ureteroscopy, shock wave lithotripsy, or percutaneous nephrolithotomy. If the kidneys have stopped working, patients might need to be placed on dialysis to support healthy kidney function. In severe cases, a kidney transplant might be the best option for this condition, but it can be difficult for patients to be approved for this kind of care due to the systemic nature of their condition.
Primary Hyperoxaluria cannot be prevented. This condition is hereditary. If an intestinal health issue has led to Hyperoxaluria, treating the underlying intestinal health issue could help prevent Hyperoxaluria symptoms. If the diet of the patient is causing Hyperoxaluria, adjusting the diet can make a big difference in the patient’s quality of life.