Do you often get kidney stones? Or does your little one get them? Maybe the reason for this is that you have too much of a chemical called oxalate in your urine. This condition is what we call hyperoxaluria in medical science. Don't be scared when you hear this name, it's very simple. Let's talk about this clearly and in a way that you can understand.
Simply put, what is Hyperoxaluria?
Oxalate is a chemical that is naturally produced by our bodies and is also found in some of the foods we eat. Normally, our kidneys filter these oxalates out of the body in the urine.
However, in a person with hyperoxaluria, the amount of oxalate in their urine increases too much. This can be dangerous. This excess oxalate combines with the calcium in the urine to form kidney stones and calcium oxalate crystals .
These stones and crystals can damage your kidneys and reduce their function. Over time, this can even lead to kidney failure . Not only that, but this excess oxalate can also start to deposit in other tissues and organs in the body.
What are the main types of Hyperoxaluria?
There are three main types depending on the cause of this condition. Once you understand these differences, it is very easy to understand.
| Type of hyperoxaluria | A simple explanation |
|---|---|
| Primary Hyperoxaluria (PH) | This is a genetic disease , meaning it is inherited. What happens here is that there is a defect in the enzymes in the liver that causes the body to produce oxalate out of control. This is the most serious of the three types. |
| Enteric Hyperoxaluria | This is caused by diseases of the digestive system (intestinal tract) . For example, people with conditions such as Crohn's disease or inflammatory bowel disease absorb more oxalate from their intestines. This condition can also occur after some weight loss surgeries (gastric bypass surgery). |
| Dietary Hyperoxaluria | It's very simple. It's caused by eating too many foods high in oxalates . Things like spinach, beets, soy, almonds, and potatoes are high in oxalates. |
Who gets this? At what age?
Symptoms of hyperoxaluria can appear at any age, from infants to adults, but symptoms usually appear around the age of 5.
- People with Primary Hyperoxaluria (PH) often develop kidney stones repeatedly during childhood or adolescence (usually before the age of 20). If this condition develops in a young child, it can be quite serious.
- In both the enteric and dietary types, kidney stones and other symptoms often appear in adulthood.
What are the symptoms of this condition?
Often the first symptom is kidney stones. But not everyone develops kidney stones. Let's look at the main symptoms.
| Common symptoms | |
|---|---|
| Blood in the urine | Recurrent urinary tract infections (UTIs) |
| Failure to thrive in young children | |
| Symptoms caused by kidney stones | |
| |
Important: Kidney stones in a young child can often be a symptom of this condition, Hyperoxaluria. Therefore, if you see something like this , take your child to a doctor without delay.
Why does this happen? Who is at higher risk?
As we discussed earlier, there are three reasons:
- Genetic defect (Primary hyperoxaluria): Something that is inherited from parents to children.
- Intestinal diseases: Excessive absorption of oxalate due to diseases of the digestive system.
- Diet: Excessive consumption of foods high in oxalate.
There are several situations that may increase the risk of this condition:
- If someone in your family has Primary Hyperoxaluria.
- If you frequently develop kidney stones.
- If you have had kidney stones during childhood (even once).
- If the doctor has told you that calcium is deposited in your kidneys.
What complications can this cause?
The main and most dangerous complication of hyperoxaluria is kidney damage and kidney failure.
When the kidneys fail, they are unable to excrete the excess oxalate that accumulates in the body. Then, these oxalate crystals start to deposit in other parts of the body, such as the bones, blood, muscles, heart, and eyes. We call this condition Oxalosis .
Oxalosis can cause other health problems:
- Bone disease
- Anemia
- Heart and eye problems
- Problems related to children's growth and development
How do I find out if this is available?
Your doctor will ask you about your symptoms, family medical history, and your diet. He or she will then order several tests to confirm the diagnosis.
- Urine tests: Measure oxalate and enzyme levels in the urine.
- Blood tests: Check kidney function and the amount of oxalate in the blood.
- Imaging tests: X-rays, ultrasound, or CT scan can be used to check for kidney stones or calcium oxalate crystals.
- Genetic testing: If there is suspicion of Primary Hyperoxaluria, this test is performed to confirm whether the genetic mutation that causes it is present.
Sometimes, you may need to have special tests, such as an echocardiogram , eye exams, or bone marrow biopsies, to see if oxalate is deposited elsewhere in your body.
How is it treated?
The main goal of treatment is to reduce oxalate levels in the body and prevent and protect the kidneys and other organs from crystal formation. Treatment depends on the type of hyperoxaluria you have and the severity of the condition.
Medication
- People with primary hyperoxaluria are given high doses of vitamin B6 (pyridoxine) to reduce oxalate levels.
- Medications such as potassium citrate are given to prevent the formation of calcium oxalate crystals.
- People with Enteric Hyperoxaluria are advised to take calcium supplements with meals because calcium binds to oxalate and helps it be more easily excreted from the body.
Changes in lifestyle and diet
- Drink plenty of water: It is essential to drink about 3 liters of water a day. This will help flush out excess oxalate with urine and prevent the formation of stones. This is very important for all types.
- Diet: Reduce salt and sugar. Limit animal proteins like meat, dairy, and eggs. Avoid foods high in oxalates (spinach, rhubarb, beets, chocolate, tea, nuts).
- Calcium-rich foods: Adding calcium-rich foods to your meals can help reduce oxalate levels.
But remember, this diet cannot have much effect on the genetic condition called Primary Hyperoxaluria. It definitely requires drug treatment.
Management for kidney stones
Some kidney stones will pass on their own when you drink plenty of water. If they don't, your doctor may have to remove them.
Dialysis or transplants
If the disease becomes severe and the kidneys fail, kidney dialysis may be required to clean the blood. If the condition of Primary Hyperoxaluria is severe, a kidney or liver transplant may be necessary.
When should you see a doctor?
Since this is the first sign of kidney stones, see a doctor immediately if you think you have kidney stones, especially if you have these symptoms:
- Pain in the back, flank, or lower abdomen.
- Red, pink, or brown urine.
- Change in the frequency or amount of urination.
- Pain when urinating.
It's normal to feel scared and anxious when you learn that you have a disease like this. Talk to your doctor, family, and friends about your concerns. Remember, with the right treatment, you can manage this condition well and stay healthy.
Take-Home Message
- Hyperoxaluria is a condition in which increased oxalate levels in the urine can lead to kidney stones and kidney damage.
- There are three main types of this: primary, enteric, and dietary.
- If you are having frequent kidney stones, especially in a young child, it could be a sign of this condition. See a doctor immediately.
- Treatment includes medication, drinking plenty of water, and limiting certain foods.
- You can prevent kidney damage by following your doctor's instructions exactly.
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