Hyperoxaluria and Oxalosis

Hyperoxaluria and Oxalosis

Overview

Hyperoxaluria occurs when there is a build-up of oxalate compounds in the urine. Oxalate compounds are naturally-occurring and found in foods like rhubarb. Excess oxalate in the urine can combine with calcium and form kidney stones. Recurrent kidney stones can cause scarring and loss of kidney function. With loss of kidney function, excessive oxalate will begin to build up in other organs as well, such as the bones, heart, skin and eyes. This is called systemic oxalosis.

Signs and symptoms

The first symptom of hyperoxaluria is usually a kidney stone. The patient will most likely experience pain in the lower back and sides, vomiting, pain while urinating, cloudy urine and fever. While kidney stones could be caused by a variety of lifestyle factors in older adults, in children and young adults, it often indicates an underlying disorder like hyperoxaluria.

Causes and Risk Factors

Primary hyperoxaluria is a rare genetic disorder wherein the liver cannot produce the enzymes that regulate oxalate production in the body. Patients with primary hyperoxaluria usually develop kidney stones in early childhood. Enteric hyperoxaluria is caused by an underlying case of Crohn’s disease or Short Bowel Syndrome, increasing the absorption of oxalate into the body. Hyperoxaluria could also be caused by consuming a diet that is high in oxalates.

Complications

Untreated hyperoxaluria can create complications such as kidney failure and systemic oxalosis. The systemic oxalosis, in return, can cause heart, eye and bone problems.

Diagnosis

The doctor will start with patient medical history and description of their diet. They will also need a panel of blood tests, urine tests and ultrasound or CT scans to check for kidney stones. If the initial tests point towards hyperoxaluria, the doctor may require additional tests including an echocardiogram to check for oxalate deposits in the heart, eye tests, a bone marrow biopsy and genetic tests to check for hereditary hyperoxaluria.

Treatment

The treatment protocol depends on the type of hyperoxaluria, whether it has progressed to systemic oxaluria and the patient’s age and general health. The doctor may recommend medication, high fluid intake and some dietary changes to reduce the oxalate build-up in the body. If the patient has developed kidney stones, they may be removed surgically or be allowed to pass naturally. Severe hyperoxaluria can cause loss of kidney function requiring dialysis treatment or a kidney transplant surgery. Patients with primary hyperoxaluria may need combined Liver kidney transplant.

Prevention

Patients who are at risk of hyperoxaluria should be screened regularly.

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