Most people think kidney stones only happen to those who don’t drink enough water or consume too much salt. But there’s another condition that can quietly increase your risk for kidney stones and cause other uncomfortable symptoms: hyperoxaluria. It’s more common than many realise.

If you’ve been experiencing unexplained pain, persistent fatigue, or have had multiple kidney stones, hyperoxaluria could be the underlying cause. Here’s what you need to know about this condition.

 What is Hyperoxaluria?

 Hyperoxaluria occurs when your body produces excessive amounts of oxalate, a naturally occurring compound found in foods like spinach, rhubarb, and nuts, as well as produced through metabolic processes. Under normal circumstances, oxalate is eliminated through urine. However, when levels become too high, it binds with calcium to form calcium oxalate crystals, which primarily result in kidney stones.

Beyond kidney stones, hyperoxaluria can trigger digestive symptoms and potentially progress to chronic kidney disease. Early recognition of the signs is crucial for maintaining quality of life.

Symptoms of Hyperoxaluria: What to Look Out For

The symptoms of hyperoxaluria can differ based on how severe the condition is. Some people may not experience symptoms at all, while others might suffer from recurring kidney stones, abdominal pain, and gastrointestinal issues. Here are some common signs that you might be hyperoxaluric:

•   Recurrent Kidney Stones: The main symptom of hyperoxaluria is the formation of kidney stones. If you have a history of frequent kidney stones, especially calcium oxalate stones, hyperoxaluria could be the reason.

•   Painful Urination: As kidney stones form and travel through the urinary tract, they can cause sharp pain, particularly when you urinate. This may come with a feeling of urgency or blood in the urine.

•   Abdominal Discomfort: Hyperoxaluria can lead to gastrointestinal issues like bloating, cramps, and diarrhoea. Some people may experience ongoing digestive discomfort due to how oxalate affects gut absorption.

•   Fatigue: High oxalate levels can cause systemic inflammation, which may contribute to feelings of tiredness and overall discomfort. If you feel unusually exhausted, it might be worth checking for hyperoxaluria.

•   Frequent Urinary Tract Infections (UTIs): In some situations, hyperoxaluria can lead to frequent UTIs, particularly in those prone to kidney stones or who have trouble passing them.

•   Bone or Joint Pain: Chronic hyperoxaluria can impact bones and joints due to calcium depletion, resulting in pain and a higher risk of fractures.

What Causes Hyperoxaluria?

The condition falls into two categories: primary and secondary.

1. Primary Hyperoxaluria

This rare genetic disorder causes the liver to overproduce oxalate due to an enzyme defect that impairs oxalate breakdown. It’s typically inherited, and affected individuals may develop kidney stones and kidney failure early in life.

2. Secondary Hyperoxaluria

This more common form results from dietary factors or other health conditions. High consumption of oxalate-rich foods (spinach, chocolate, sweet potatoes) or digestive disorders like Crohn’s disease that impair nutrient absorption can trigger this type. Certain intestinal surgeries also increase oxalate absorption.

Other Contributing Factors

Gastrointestinal Surgery: Surgeries like weight loss surgery can affect the small intestine and lead to more oxalate absorption.

Dehydration: Not drinking enough water can contribute to kidney stone formation, especially in people with high oxalate levels.

ChronicDiarrhoea: Conditions causing diarrhoea can hinder calcium absorption and help raise oxalate levels.

 How Is Hyperoxaluria Diagnosed?

 To diagnose hyperoxaluria, a gastroentrology specialist will likely conduct a urine test to measure the oxalate in your urine over a 24-hour period. This is often followed by blood tests, imaging studies like ultrasounds or CT scans to check for kidney stones, and possibly a genetic test if primary hyperoxaluria is suspected.

Since the symptoms of hyperoxaluria can overlap with those of other digestive or urinary conditions, it’s essential to work with an experienced gastroenterologist or nephrologist who can accurately identify and manage your condition.

 Treatment Options for Hyperoxaluria

 Hyperoxaluria treatment varies based on cause and severity:

•  Dietary Modifications: Limit high-oxalate foods like spinach, nuts, beets, and sweet potatoes to reduce oxalate levels, especially for secondary hyperoxaluria.

•  Increase Fluid Intake: Drink plenty of water to dilute urinary oxalate and reduce kidney stone risk.

•    Calcium Supplementation: Calcium binds to oxalate in the gut, preventing absorption and reducing urinary excretion.

•  Medications: Potassium citrate increases urine pH and calcium oxalate solubility, helping prevent stone formation.

•  Vitamin B6: Supplementation may reduce hepatic oxalate production.

•  Advanced Interventions: Severe primary hyperoxaluria with kidney failure may require dialysis or kidney transplantation.

•  Dialysis (in Severe Cases): In extreme cases of primary hyperoxaluria that lead to kidney failure, dialysis or even a kidney transplant may be required.

 Prevention Strategies

Preventing hyperoxaluria requires a combination of dietary adjustments and lifestyle modifications:

•   Dietary Changes: Reduce consumption of high-oxalate foods while maintaining adequate calcium intake to minimise oxalate absorption.

•   Stay Hydrated: Drink sufficient water throughout the day to dilute urine and lower the risk of stone formation.

•   Regular Monitoring: If you have a history of kidney stones or hyperoxaluria, schedule routine check-ups with your healthcare provider to track kidney function and oxalate levels.

Why You Should See a Gastroenterologist

Since hyperoxaluria often stems from digestive issues, consulting a gastroenterologist is essential. Consider visiting gastroenterologists, such as Dr Fernandes Mark Lee, who have expertise in diagnosing and treating complex digestive conditions related to hyperoxaluria. They understand how gut health affects oxalate levels and can provide comprehensive care tailored to your needs.

 Conclusion

 Hyperoxaluria may not always come to mind when considering kidney stones or digestive issues, but it can quietly impact your health in significant ways. By recognising symptoms early, working with a skilled specialist, and making specific lifestyle changes, you can effectively manage this condition and improve your overall quality of life.

 If you’re experiencing symptoms of hyperoxaluria or have a history of kidney stones, consider seeking the guidance of a gastroenterologist like Dr Fernandes Mark Lee, who can help create a tailored treatment plan for you. Hyperoxaluria might be a hidden issue, but with the right care, you can manage it and live without symptoms.