Oxaluria - symptoms, causes and treatment. Oxalic acid and oxalates in food and in your body Oxaluria causes

Oxalates in a child’s urine indicate possible diseases of internal organs or poor nutrition.

The cause is oxalic acid, the salts of which can accumulate in the body and be deposited in the form of stones, causing urolithiasis and kidney failure.

What is oxaluria?

This disease is characterized by increased levels of oxalic acid salts (oxalates) which fall out as sediment. This causes the development of other pathologies. The main reason for the appearance of oxalates in the urine is the consumption of foods rich in oxalic acid and metabolic disorders.

Oxalates are poorly soluble in water, so they tend precipitate and crystallize. They settle in the kidneys and on the walls of other organs of the urinary system in the form of sand and stones. As a result, a disease develops - oxalate crystalluria (oxaluria or oxaluria).

If you consume large amounts of food high in oxalic acid for a long time, hyperoxaluria may occur.

Oxalates do not have time to be eliminated by the body, and acute poisoning with these compounds occurs. For children the lethal dose of oxalic acid is 5-20 g. The patient's kidney function is impaired, liver tissue necrosis occurs and cardiac arrhythmia develops. In the most severe cases, death is possible.

Norm of oxalates in urine

To determine the level of oxalates, you should collect. The first morning portion is not taken. The collection begins with the second urination and ends with the morning collection the next day.

Urine is collected in a sterile container and stored in the refrigerator. After collection is complete, shake the contents thoroughly and measure out 100 ml for analysis. Next, the biomaterial is sent to the laboratory indicating the total amount of urine per day.

U children of different ages the standards are different:

  • children under 3 years of age – 0.5 mg/kg per day;
  • 3-5 years – ~12 mg/kg per day;
  • over 5 years – no more than 20 mg/kg per day.

A single excess of oxalate levels is not always a pathology.

This may be due to eating foods high in oxalic acid the day before. To confirm you need to do reanalysis.

Low levels of oxalates, according to Dr. Komarovsky, are present in the urine of all categories of the population and do not cause harm.

Reasons for deviation from the norm

There is a whole a number of reasons that can cause increased urinary oxalate levels:

  • congenital genetic disorders (related to calcium absorption);
  • excessive consumption of foods high in oxalic acid;
  • dehydration or insufficient fluid intake;
  • metabolic disorders;
  • disruption of the digestive system;
  • chronic gastrointestinal diseases;
  • excess ascorbic acid;
  • diseases of internal organs;
  • lack of enzymes;
  • excess or deficiency of B vitamins;
  • abuse of salt and salty foods;
  • poor nutrition;
  • intestinal dysbiosis.

Increased levels of oxalate in the urine are not always associated with excess oxalic acid in the diet. The reasons may lie in the body itself, which is not able to remove the breakdown products of this organic compound.

In this case it is possible metabolic disorder or weakness of the child’s excretory system, which cannot cope with even small amounts of oxalates. As a result, they accumulate and are periodically released along with urine.

In infants, the pathology is associated with the mother's nutrition, which affects the composition of breast milk. If you do not adhere to your diet and overuse fruits, herbs and vegetables with a high content of oxalic acid, this can affect the infant. Even strong tea and coffee are potentially dangerous products.

Associated symptoms

The main symptom is disturbance of normal urination. Your child may have a frequent urge to urinate. At the same time, the amount of urine constantly deviates in different directions.

In parallel with this, a change is possible - it becomes bright and rich due to the presence of a large amount of salts and acquires a characteristic pungent odor.

At the same time, children become more capricious and lethargic. Their sleep is disturbed and abdominal pain appears. There is general weakness, apathy and loss of appetite. Infants may refuse to breastfeed.

Possible complications

Lack of treatment leads to the accumulation of salts in the body child. As a result, sand and stones form in the organs of the urinary system, and develops. This can cause kidney failure, metabolic disorders and blockage of the excretory system.

The sharp edges of the crystals damage surrounding tissue, causing pain and internal bleeding. In such a situation, the chances of infection entering through cuts increase, so the pathology is often accompanied by other diseases with inflammation of internal organs and tissues.

In the most severe cases, kidney failure may occur, followed by fatal.

Find out the symptoms of kidney failure in our article.

How to normalize the level?

Therapy for the disease should be comprehensive and include the use of medications simultaneously with a therapeutic diet.

This is necessary to reduce the intake of oxalic acid into the body with food and normalize metabolism.

Drugs

Used in treatment the following drugs:

  • Membrane stabilizers - prevent the accumulation of calcium salts in cells and stimulate their excretion (vitamin A, vitamin E, Dimephosphone).
  • Xidifon - regulates calcium levels in the body and prevents the deposition of oxalates.
  • Enterosorbents – promote the removal of oxalates from the intestines (Enterosgel, activated carbon, Smecta).
  • Probiotics – have a beneficial effect on the intestinal microflora and normalize metabolism.

Diet

Nutrition is one of the most important elements in the treatment of oxaluria.

To begin with, you should give your child plenty of fluids to speed up the elimination of salts. Then follows exclude from diet the following products:

  • sorrel;
  • spinach;
  • rhubarb;
  • cocoa and chocolate;
  • figs;
  • smoked meats;
  • spicy food;
  • salt and salty foods;
  • marinades;
  • products containing gelatin;
  • fatty soups and broths.

Helps remove oxalates foods high in vitamin B6, so they must be included in the child’s diet:

  • seaweed;
  • prunes (dried fruit);
  • buckwheat;
  • pearl barley;
  • oatmeal.

Should be moderate in consumption the following products:

  • potato;
  • carrot;
  • tomatoes;
  • beet;
  • garlic;
  • plums;
  • currant;
  • blueberry.

To obtain protein foods from your body, it is recommended to consume lean meats and fish. It is better to cook food boiled, then you can lightly fry it. It is allowed to stew food, but you still need to boil it first. This is necessary to reduce the formation of purine compounds in products.

In this case, you should eat little by little, but often (6-8 times a day). Small portions of food are digested faster and do not overload the body. Meals should be accompanied by plenty of drinking 30-40 minutes after the meal. Best for this use the following drinks:

  • dried fruit compotes;
  • birch sap;
  • decoction of (corn silk or dill);
  • fresh fruit or vegetable juices;
  • filtered and boiled water;
  • special dietary water for children in bottles.

Oxalates in a child’s urine are a dangerous phenomenon. It could be symptom of a serious illness, therefore it is necessary to carefully examine and cure the disease. If measures are not taken in time, there is a risk of disruption of the functioning of internal organs, and in the most severe cases, death is possible.

Find out from Elena Malysheva what products form urates and oxalates in urine:

If, according to the results of the analysis, an increased content of oxalates is detected in the urine, this is a reason for an urgent visit to the doctor.

This is one of the types of salts that form a crystalline precipitate, the presence of which can cause serious health problems. Oxaluria (oxaluria), or an excess of oxalates in the urine, leads to the formation of angular stones that injure the mucous membrane of the renal tubules, bladder, and urethra. The result is pain, blood in the urine (hematuria), inflammation. Oxaluria can be a symptom of diabetes and other dangerous diseases. Timely treatment, including drug therapy and diet, will help get rid of this problem.

Salts under magnification

Oxalates are salts of oxalic acid, which, when combined with calcium, ammonium and sodium, precipitate in the urine in the form of crystals. Oxalic acid enters the body both from the outside, with products containing it, and from the small intestine, where it is formed during the oxidation of vitamin C. Its main source is greens (sorrel, spinach), vegetables (tomatoes, potatoes), some fruits, nuts (in in particular, walnuts).

As a rule, the formation of oxalates results from the combination of oxalic acid with calcium, and in rare cases - with other substances. The appearance of the sediment is layered crystals with an uneven surface, replete with spines and bumps, grayish, brown (with hematuria) or black. The needle-shaped surface causes microtrauma to the tissues of the kidneys, bladder, and urethra, which in turn leads to minor hemorrhages and blood in the urine. One of the most dangerous consequences is the appearance of oxalate stones in the kidneys, which reach several centimeters in diameter. Such stones can only be removed surgically.

Reasons for education

Compounds of oxalic acid and minerals are insoluble. Normally, they are 95% excreted from the body, and only a small part remains in the urine. Their excess indicates a disturbed metabolism and poor functioning of the urinary system: the kidneys cannot cope with the excretion of oxalates. Another risk factor is increased or decreased acidity of urine: normal pH is 5-7 units, deviation from this norm in one direction or another contributes to the formation of sediment. Urine with high or low pH is a symptom of a number of diseases.

Small crystals provide a base on which additional layers can grow, leading to the formation of large oxalate stones. Most of these stones (up to 80%) are calcium oxalates.

Norm of oxalates in urine

A healthy person's urine always contains a small amount of oxalates. Oxalic acid is necessary for good absorption of calcium and other minerals by the body; only its excess is dangerous. The normal daily oxalate content in children is up to 1.3 mg, in adults – up to 40 mg.

The norm of oxalates for men and women is slightly different: in men this figure is higher and can reach 40-42 mg per day, while in women the norm is up to 30-32 mg. This is because men tend to weigh more and eat more food. At the same time, metabolism in both sexes proceeds in a similar way; no fundamental differences in metabolism have been identified.

Main reasons

There are two main types of oxaluria – primary and secondary. Primary is caused by oxalosis, a disease that is inherited. It is characterized by excessive formation of oxalic acid in the body itself. This disease is rarely observed. Secondary oxaluria occurs more often. Among the reasons that can cause it are the following:

  • Poor nutrition with an excess of foods rich in oxalic acid: potatoes, spinach, rhubarb, sorrel, tomatoes, oranges, lemons, walnuts, beets, asparagus, cocoa and products containing it (chocolate, baked goods);
  • Lack or deficiency of vitamin B6 or magnesium in the diet;
  • Increased levels of vitamin D or ascorbic acid in the body;
  • Dehydration as a result of exhaustion, stress, exposure to a hot and dry atmosphere;
  • Poisoning from ethylene glycol, which is contained in brake fluid, glass cleaner or antifreeze;
  • Intestinal diseases, including Crohn's disease;
  • Surgeries on the gastrointestinal tract, causing inflammation or penetration of infections into the intestines;
  • Pyelonephritis and glomerulonephritis;
  • Liver dysfunction;
  • Diabetes mellitus;
  • Inflammatory diseases of the bladder (cystitis) and urethra (urethritis).

Symptoms

Often oxalaturia is asymptomatic and is detected only by the results of a urine test. In some cases, the following symptoms are typical for high oxalate levels:

  • Hematuria (blood in the urine).
  • Frequent urination.
  • Increased urine production (polyuria).
  • Fatigue.
  • Muscle weakness.
  • Insomnia.
  • Headaches.
  • Pain in the lower abdomen.
  • Painful spasms indicating renal colic. In this case, the pain is acute, sharp, cramping, radiating to the lower abdomen, lower back, legs or groin. Since the cause of colic is a violation of the outflow of urine, it requires urgent hospitalization before the patient’s condition becomes dangerous.

Oxalates during pregnancy

Increased levels of oxalates in the urine in pregnant women can occur for the same reasons as listed above. In addition, the following risk factors are identified:

  • A higher than usual likelihood of developing inflammatory diseases - cystitis, urethritis, pyelonephritis.
  • Dehydration that occurs when fighting edema, when pregnant women are advised to drink less.
  • Hypervitaminosis, which occurs with excessive consumption of vegetables and herbs, or uncontrolled intake of multivitamin complexes.
  • Double load on the kidneys during pregnancy - they work on the body not only of the mother, but also of the child.

The symptoms of oxaluria are the same as those of other patients - frequent urination, increased fatigue, pain in the lower abdomen.

Diagnostics

The primary diagnosis is made based on a urine test. The sediment may contain not only oxalates, but also other substances that help identify the cause of oxaluria:

  • The presence of urates (compounds of uric acid with sodium and potassium) indicates inflammatory diseases, dehydration, chronic renal failure, urolithiasis, leukemia or gout.
  • The presence of protein along with oxalates indicates common infectious diseases (scarlet fever, osteomyelitis or hepatitis), and it is also a symptom of high temperature or physical exertion. Normally, there should be no protein in the urine.
  • Phosphoric acid compounds (phosphates) are a sign of low acidity of urine, which can be a symptom of diabetes mellitus or rickets in children.
  • A high leukocyte count is a sign of an inflammatory process accompanying cystitis, urethritis or pyelonephritis.

Usually two urine tests are taken: general and biochemistry. In addition, other studies may be carried out - in particular, ultrasound of the kidneys, or computed tomography, which will show the presence or absence of stones. If necessary, your doctor may suggest a bone marrow biopsy to look for salt deposits in the bones, a kidney biopsy, or a cardiac echocardiogram to show if there are oxalates in the heart muscle.

Treatment methods

Treatment of oxaluria is usually complex and includes the following techniques:

Drug treatment

Patients are prescribed medications containing magnesium and vitamin B6 to remove oxalates from the body. Such drugs are contraindicated for diabetes mellitus or stomach ulcers. Another contraindication is anemia, due to the fact that iron is excreted along with calcium.

Other medications are also used to treat oxaluria:

  • Diuretics that help flush out salt deposits.
  • Medicines that reduce the risk of stone formation (for example, sodium citrate).
  • Antibacterial and anti-inflammatory drugs (in case of inflammatory diseases of the kidneys, bladder, urinary tract).

Diet and drinking regime

Oxalates take longer to dissolve than other crystals, so you need to follow the diet for a long time. You need to drink up to two and a half liters of liquid per day. In addition to clean water, you can drink non-carbonated mineral water, herbal teas, carrot, rowan, lingonberry juice or dried fruit compote. A good water substitute is light vegetable soup. Black tea and coffee, which lead to dehydration, should be excluded from the diet.

The diet for oxaluria includes:

  • Dairy products (milk, fermented baked milk, kefir, yogurt).
  • Boiled and stewed lean meat, lean fish, poultry, especially chicken.
  • Bread and baked goods made from wholemeal flour, as well as bread with bran or fiber.
  • Oatmeal, buckwheat, pearl barley porridge.
  • Dried fruits and decoctions from them.
  • Products containing magnesium and vitamin B6.
  • Vegetables and fruits low in oxalic acid (peaches, pineapples, apricots, bananas, cabbage, pears, cucumbers, turnips, pumpkin).
  • Pasta.

It is necessary to exclude alcohol, chocolate, cocoa, meat and fish soups, fatty, spicy foods from the diet. In addition, the following are contraindicated:

  • Any nuts.
  • Greens containing oxalic acid (sorrel, asparagus, rhubarb, spinach).
  • Vegetables and fruits with a high content of oxalic acid: potatoes, tomatoes, eggplants, zucchini, beets, sweet peppers, apples, grapes, raspberries, blackberries, currants, kiwi, citrus fruits, gooseberries, persimmons, figs.

Traditional medicine recipes

In addition to drug treatment and diet, you can use folk remedies - decoctions and infusions of herbs, tree buds, and berries. Most often, such products include the following components:

  • Horsetail.
  • Peppermint.
  • Lingonberry and strawberry leaves.
  • Birch buds.
  • Bird's knotweed.
  • Corn silk.
  • Nettle leaves.
  • Linden color.
  • Rose hips.
  • Lingonberry berries.
  • Bearberry, also known as bear's ears (as a diuretic).
  • Oats.

If oxaluria has led to the formation of large stones, they resort to lithotripsy - a procedure for crushing stones that later pass naturally, or lithotomy - an operation to remove stones from the bladder, ureters, or renal pelvis.

Prevention

To prevent excess oxalate in urine, the following measures are recommended:

  • Balanced diet - do not overuse foods containing a lot of oxalic acid.
  • Moderate alcohol consumption. Avoid substitutes that may contain ethylene glycol and alcohol substitutes (such as antifreeze) that are hazardous to health.
  • Compliance with the drinking regime - the norm for a child is to consume 1-1.3 liters of fluid per day, the norm for adults is 2-2.5 liters.
  • Monitoring the condition of the gastrointestinal tract - ulcers, gastritis and other diseases can provoke oxaluria.
  • Increased attention to health status against the background of diseases such as diabetes.
  • Regular visits to the doctor.

With timely treatment, the prognosis is usually favorable, but to completely get rid of the disease you need to control your diet and lead a healthy lifestyle. Self-medication is strictly prohibited - at the first signs of oxaluria you should consult a doctor.

Oxaluria is a condition when a lot of oxalic acid salts (oxalates), which are sharp, hard crystals, are formed in the kidneys. When excess oxalates are combined with inflammation of the mucous membrane of the pelvis, the formation of kidney stones occurs. In this case, they talk about nephrolithiasis (urolithiasis) of oxalate nature. An increased content of oxalic acid salts can be secondary (acquired) or primary (a consequence of congenital pathologies of salt metabolism). In the second case, oxaluria is diagnosed in children of various ages. What contributes to the increased formation of oxalic acid salts in the excretory organs, on the basis of which the diagnosis is made, and how doctors confront the pathological condition, you will find out by reading the article.

Causes of oxaluria

The first question that arises for patients who have heard a doctor’s verdict about their oxaluria is what is it and where did it come from? There may be several factors contributing to the excessive formation of oxalates (mainly calcium oxalate salts), so the pathology is classified as polyetiological. In the formation of oxaluria, in addition to hereditary causes and congenital metabolic disorders (enzyme deficiency), several other factors take part, such as:

  • disturbance of calcium-magnesium metabolism (with a lack of magnesium, increased crystallization of calcium salts occurs, including in the renal tubules);
  • increased absorption of calcium in the intestine (excess vitamin D, inflammatory bowel disease, dysbiosis);
  • nutritional factor (excessive consumption of foods containing oxalic acid);
  • lack of B vitamins, especially pyridoxine and thiamine, which regulate salt metabolism;
  • excess ascorbic acid, which enhances oxidative processes, including the interaction of calcium with oxalic acid;
  • renal disorders (nephropathies), in which the stability of the cell membranes of functional tissue is disrupted.

Regardless of the predominant causes, oxaluria is characterized by massive formation of oxalate crystals in the kidney tubules during the formation of secondary urine. If the function of the excretory organ is not reduced, the crystals are successfully excreted in urine, although they irritate the mucous membrane of the pelvis and ureters, provoking the development of inflammation. If the mucous membrane becomes inflamed, oxalates stick to the membrane due to the viscous secretion released, and the process of formation of oxalate kidney stones begins.

Important! Urolithiasis, which occurs with the formation of oxalate stones, requires only surgical treatment - such stones are very dense and difficult to destroy (crushing).

Symptoms accompanying the pathology, diagnosis


Oxaluria can be detected in both adults and children. It is characteristic that in young children this pathology of salt metabolism occurs without any external manifestations. In older children and adult patients with oxaluria, the symptoms are as follows:

  • fatigue;
  • neurological disorders (headache, irritability);
  • pain in the abdomen and the area where the kidneys are located (lower back), renal colic in the form of isolated attacks;
  • increased diuresis (daily volume of urine excreted).

When analyzing urine, oxalate crystals are found in the sediment, sometimes protein, red blood cells, and white blood cells (if inflammation of the mucous membrane occurs). If the formation of oxalic acid salts in the kidneys is moderate, the symptoms will not be clearly expressed. With significant formation of oxalates, disturbances in the renal circulation may occur, which will lead to the appearance of pinpoint necrotic foci in the functional tissue of the organ and the addition of inflammatory processes (nephritis).

Excessive formation of oxalic acid crystals leads to the formation of salt deposits in the kidney tissues (nephrocalcinosis). This condition is fraught with the development of renal failure and azotemia. Nephrocalcinosis is dangerous because both kidneys are symmetrically affected, which poses a serious threat to health. With the massive formation of oxalates in cases of severe forms of oxaluria, calcium oxalate salts are deposited even in skeletal muscles, leading to their dysfunction, and bones. Sometimes hypercalcinosis leads to skin and pulmonary pathologies.

To diagnose oxaluria, the main methods are laboratory tests of urine. Urine is tested for the content of oxalate salts and their amount in the sediment. Also of diagnostic importance are indicators such as microerythrocyturia, microproteinuria, the presence in urine of markers of cell membrane instability in the absence of indicators indicating renal tubular dysfunction.

Treatment of oxaluria

The method of treating the pathological condition includes nutritional correction (diet for oxalaturia), medications to influence salt metabolism and surgical interventions in the development of complications (urolithiasis of oxalate origin).

One of the effective, but at the same time simple ways to combat excess oxalate salts in urine is to significantly increase the volume of water drunk per day, which leads to increased urine formation and a decrease in the concentration of salt crystals in urine. However, this method is contraindicated in renal failure, arterial hypertension, and severe forms of heart failure. Considering that increased formation of oxalates occurs when urine is acidic, it is advisable, especially at night, to drink alkaline mineral water containing bicarbonates (soda).

Medications are also actively used in the treatment of oxalaturia. To correct salt metabolism and prevent massive formation of oxalates, the following pharmacological drugs are now used:

  • substances with membrane-stabilizing and antioxidant effects (vitamins A and E or their complex preparations (Aevit)), reducing the permeability of renal cell membranes and the intensity of oxidative processes;
  • vitamins that optimize salt metabolic processes (B6, B2, B1);
  • the medicine Xidifon regulates calcium metabolism at the cellular level, prevents the deposition of the mineral in the tissues of the body (kidneys, including);
  • probiotics are prescribed for severe intestinal dysbiosis (restoration of normal microflora helps reduce the absorption of calcium into the blood).

There are several effective traditional medicine recipes that help reduce the formation of oxalate crystals in the kidneys. This is a decoction of oats, herbs (knotweed, pol-pal, bearberry), brewer's yeast.

Dietary restriction for oxaluria


If oxalaturia is diagnosed, the diet implies exclusion (or maximum limitation) from the diet, first of all, of foods with a high content of oxalic acid. These include rhubarb, spinach, cocoa, figs, and sorrel. Also excluded are foods that shift the urine reaction to the acidic side (fatty meat dishes, rich broths, pickles, smoked foods, hot seasonings and spices, marinades and jellies (containing gelatin)).

Indicated for oxalaturia are fruits that stimulate the excretion of oxalic acid salts from the body, foods rich in B vitamins (cereals, seaweed, prunes), vegetables (contain a lot of fiber that normalizes intestinal function).

The principle of nutrition for oxaluria should be based on frequent consumption of fractional portions of food (up to 6-7 times a day) with plenty of water in between meals.

The formation of kidney stones or oxaluria in children and adults occurs as a result of the formation of calcium oxalate in the urine, which is the founder of 75% of all urolithiasis. For this reason, if kidney stones are suspected, an examination is carried out, including measurement.

What is oxaluria?

The term oxaluria (from the Greek oxalis - sorrel and uron - urine) means the formation of calcium oxalate sediment (a disorder of the metabolism of oxalic acid salts) in the urine. Every day, 0.02 grams of oxalic acid is excreted from the human body, but this amount increases by eating sorrel and spinach. Calcium oxide crystals are colorless crystalline substances that dissolve in hydrochloric acid.

Causes and pathology of development

The formation of oxalate precipitate, which is considered to be a result of normal metabolism, is closely associated with symptoms of diseases of the nervous system. It manifests itself as general weakness, anxiety, headache, pain in the spine, abdomen and painful urination. Research by modern scientists has proven that the presence of oxalate sediment in the body is compatible with good health. The only danger associated with sedimentation (from the Latin sedimentum - sedimentation) of salts is that it leads to stone formation (from the Latin calculus), manifested by painful urination.

The main symptoms defining the disease

Symptoms of kidney stones include:


If there are kidney stones, they may manifest themselves as chills and fever.
  • severe sudden abdominal (persistent) pain in the side;
  • blood in urine;
  • frequent urination;
  • pain when urinating;
  • fever and chills.

Symptoms of kidney failure:

  • decreased urine production or no urine production at all;
  • feeling of pain, fatigue;
  • loss of appetite, nausea and vomiting;
  • skin color is pale, associated with anemia.

Late-stage oxalosis causes complications characterized by bone disease, anemia, skin ulcers, heart and eye problems, and in children, failure to develop and grow normally.

Why is it found in children?

Unlike adults, early onset of the disease is more often associated with various metabolic conditions in children. To prevent recurrence of stone episodes and avoid serious complications, the underlying cause of the disease in childhood is identified as soon as possible and hence treated properly. CaOx-containing stones are a common type of urolithiasis in children, at least in Western countries.

The usual metabolic evaluation of such cases includes urinary excretion of promoters (calcium, oxalate, ) and inhibitors (citrate, magnesium) of crystallization. Although idiopathic hypercalciuria is supposedly diagnosed more often than hyperoxaluria. The latter may play a more important role in the pathogenesis of CaOx urolithiasis. Even a small increase in urinary oxalate excretion accelerates the formation of CaOx crystalline mass.

Diagnosis of the disease


After examining the patient, the doctor may prescribe an x-ray of the kidneys.

An examination is performed, including a medical history and a discussion of diet. Tests to diagnose the disease include:

  • urinalysis: measuring the level of oxalate and other metabolites in the urine;
  • blood tests to determine kidney function and blood oxalate levels;
  • X-ray, ultrasound, and computed tomography (CT) scans of the kidneys to check for kidney stones or calcium oxalate deposits;

After initial testing, your doctor may recommend doing more tests to confirm the diagnosis and see how the disease has affected other parts of the body. These tests include:

  • DNA test to look for inherited causes;
  • kidney biopsy to look for oxalate deposits;
  • an echocardiogram to check for oxalate deposits in the heart;
  • a bone marrow biopsy to check for oxalate deposits in the bones;
  • liver tests to look for enzyme deficiencies.

Diet and lifestyle features

What should you do and eat?


Including milk in the diet will help stop the further development of the disease.
  • Reduce body weight as close to your ideal weight as possible by following a low-calorie diet.
  • Drink enough water to bring your urine volume to 2 liters per day.
  • Consume milk, yogurt and cheese regularly and avoid cheeses containing sodium chloride.
  • Eat fruits and vegetables, trying to avoid foods containing high amounts of oxalate.
  • Use fresh or frozen foods rather than processed or pre-cooked foods.
  • Limit your intake of animal protein by reducing your consumption of meat and its derivatives. The total amount of proteins obtained from meat, fish, chicken, eggs, milk and cheese should not exceed 50-60 g/day.
  • Avoid excessive consumption of carbohydrates. Replace sucrose with sweeteners such as saccharin or aspartame;
  • Avoid excess saturated fat by consuming omega-3 rich foods such as olive oil, anchovies, sardines and mackerel.
  • Limit sodium chloride intake to no more than 6 g/day. It is important to be aware of the “hidden sources of salt” and avoid using processed foods, which are usually very salty.
  • Do not take supplements containing vitamin D. Vitamin C supplements are allowed no more than 1500 mg/day; Avoid vitamin B6 deficiencies.

To eliminate the problem, spinach will have to be removed from the children's menu.

The diet for oxaluria in children and adults comes down to the main thing - the elimination of foods with a high content of oxalate (oxalic acid): rhubarb, spinach and beets (roots and leaves). Other oxalate-containing foods that should be eliminated include: peanuts, bran, nuts, legumes (including soy), chocolate, tea (not herbal), parsley.

Quite a lot of patients seek help from urologists regarding oxalaturia. Moreover, they often have questions not even about the disease, but about its name, which may vary. When answering the question: what is oxalaturia, one should begin by considering the type of pathology. One of the three types of urolithiasis is oxalic acid diathesis, which can otherwise be called oxalaturia or oxaluria. This pathological process is characterized by increased secretion of oxalic acid in the urine. First of all, crystals of calcium oxalate and acid are released.

The etiology of the disease is quite extensive. It includes hereditary causes (primary oxalaturia in children is provoked), many abnormal gastrointestinal phenomena, and occasionally a number of nutritional effects. The main factors provoking the development of the disease are:

  • failures in the production of enzymes that ensure the absorption and release of calcium oxalate (as a rule, these failures are hereditary);
  • excessive consumption of foods containing a lot of oxalates (cocoa, chocolate, etc.);
  • Crohn's disease;
  • ulcerative colitis, other intestinal pathologies (for example, a deficiency of lactobacilli, which causes a violation of the degradation of oxalates);
  • intestinal surgeries, some other surgical interventions;
  • deficiency of vitamins A and B6, excess of ascorbic acid;
  • environmental influence.

The conditions for the development of pathology make it possible to divide it into three groups. The first includes diseases that have polygenically inherited nephropathies, which manifest themselves due to instability of renal cell membranes. The second group consists of oxaluria in children together with some pathologies of the urinary system (pyelonephritis, homerulonephritis, etc.). In this case, the main cause is a secondary pathology within the renal cell membranes, which is a consequence of the underlying kidney disease. The third group includes pathologies with the presence of nephropathies that are a consequence of unfavorable ecology.

Symptoms of manifestation

In an adult patient, as in a child after five years of age, oxalic acid diathesis is manifested by the appearance of pain in the abdomen or lumbar region, an increased volume of urine emitted, attacks of renal colic, and rapid fatigue. Oxaluria, the symptoms of which have become noticeable, will certainly be reflected in the urine test - protein, oxalates and blood cells appear.

Oxalate deposits that appear inside the kidneys (especially large ones) can cause circulatory problems, which leads to the development of nephritis or focal necrosis. As a rule, stone formation is a consequence of colloid imbalance caused by inflammatory products in the urine. In addition, neuroses or regular headaches may appear.

In young children, oxalic acid diathesis usually occurs without noticeable clinical manifestations. Diagnosis in such cases is carried out by microscopic examination of urine. The goal is to determine the amount of oxalates in the urine.

With severe pathology, quite large salt deposits are observed in the kidneys, which over time can cause the development of nephrocalcinosis. Often, progressive nephrocalcinosis leads to renal failure. Severe cases of the disease may show signs of bone or muscle damage.

Treatment of pathology

The main method of treatment is drug therapy, however, diet for oxalaturia plays an important role. Quite rarely, only in case of complications, surgical intervention may be used.

An increased amount of water consumed helps to reduce the content of crystalloids, but this method can only be recommended if the circulatory system and kidneys are functioning normally. Patients are recommended to drink additional drinks in the evening (before bedtime); it is better to drink bicarbonate, sodium or other mineral waters. The course of taking mineral waters is designed for approximately two weeks.

Modern medicine directs drug therapy to prevent crystallization; for this purpose, antioxidants and membrane stabilizers are recommended. Treatment involves taking sodium and potassium citrate, which helps reduce the acidity of urine (changing it to the alkaline side). In addition, vitamins A, B (2 and 6), D are prescribed.

Long-term use of herbal remedies containing plant extracts with litholytic, diuretic, and anti-inflammatory properties may also be prescribed. In consultation with your doctor, you can drink various herbal teas that help dissolve oxalates and their subsequent removal. Such teas are brewed with strawberry leaves, knotweed, dill seeds, mint, corn silk, bearberry, birch buds or leaves, etc. When taking medicinal teas, you should remember that it is recommended to change the composition of the tea approximately every two weeks.

Having answered the question - what is oxalaturia, and having considered the possibilities of its treatment, you should pay attention to the nutritional characteristics of this pathology. Most experts agree that it is possible to cure oxalic acid diathesis only with an integrated approach. In this case, the basis of treatment is a special diet. The diet for oxaluria in children is based on avoiding chocolate, cocoa, citrus fruits and other foods rich in vitamin C. In addition, the consumption of butter, sour cream, baked goods and sweet fruits is limited.

For adults, the best oxalaturia diet is based on the therapeutic diet no. 5, which limits the intake of salt and carbohydrates into the body. At the same time, the use of a number of products is strictly prohibited:

  • any sausages and smoked meats, offal, herring, decoctions of meat or fish;
  • beets, tomatoes, spinach, sorrel, potatoes (fried);
  • currants, plums, cranberries, gooseberries;
  • any mushrooms;
  • alcohol;
  • coffee, tea, pepper, mustard, chocolate.

The consumption of eggs, milk, sour cream, salt, onions, garlic, boiled fish or meat is limited. All other products are allowed to be consumed in normal quantities, but preference should be given to those prepared by baking or boiling. It is recommended, along with the diet, to increase fluid intake to two liters per day, and mineral waters that have a slightly alkaline effect are especially useful.

Oxaluria, a diet in which lasts for about two weeks, naturally, if there are no serious metabolic failures, practically disappears. During this period, the balance is restored to normal values. In most patients, oxalic acid diathesis in the initial stages is eliminated without drug treatment, exclusively by strict adherence to diet.