Oxalates in urine in healthy people can be noted only in small quantities. An increase in these salts most often indicates malnutrition, as they enter the body with food. Less commonly, oxalaturia is a consequence of intestinal pathologies, vitamin deficiency or hypervitaminosis, and other diseases. If an increase in the oxalate index is found in the analysis of urine, then this is a harbinger of urolithiasis. Excessive amounts of these salts can trigger an attack of renal colic. If oxalate stones have already formed in the kidneys, then it is very difficult to get rid of them. These deposits are not susceptible to dissolution and fragmentation. Therefore, oxalaturia must be treated in the early stages, while it has not yet passed into severe urolithiasis.
What are oxalates?
Oxalate crystals in urine are oxalic acid salts that enter the gastrointestinal tract from food. Then, in the body, this compound interacts with calcium. A chemical binding reaction occurs. As a result, salts are formed - calcium oxalates or calcium oxalate.
If salts (oxalates) in urine are observed in increased quantities over a long time, then over time they turn into stony deposits. These are quite dangerous formations in the kidneys. Oxalate stones have a rough structure and many sharp protrusions on the surface. They can seriously injure the epithelium of the kidneys, which leads to the appearance of blood in the urine. Therefore, if the analysis showed an increase in the number of oxalates, then you need to review your diet and undergo a course of therapy with a urologist.
Decoding analysis and norm
These salts can be detected using a routine clinical urine test. They are determined by microscopic examination of urine sediment. The norm of oxalates in urine in an adult is from 0 to 40 mg, and in a child from 1 to 1.5 mg. If the amount of salts goes beyond these boundaries, then we can talk about oxalaturia. However, urologists believe that oxalate levels above 25 mg already carry an increased risk of urolithiasis.
In the decoding of the analysis of urine for oxalates, the normal indicator of these salts can be indicated as follows:
- up to 40 mg in 1 l;
- small or moderate amount;
- two crosses "++".
It is important to pay attention to other indicators of the analysis: the number of leukocytes, the presence of protein, urate and phosphate. The acidity (pH) of urine should also be considered. At a pH of 5 to 7 units, oxalaturia is usually not observed. If the urine has excessive alkalinity or acidity, then oxalic acid salts precipitate. In this case, an increase in oxalates is noted.
Reasons for increased oxalate
The main reason for the increased content of calcium oxalates in the urine is malnutrition. This is most often associated with excessive consumption of products containing oxalic acid. These include:
- leaf crops (sorrel, asparagus, spinach, salad);
- Tomatoes
- citrus fruit;
- beet;
- legumes;
- berries;
- potatoes;
- beet.
Excessive consumption of tea, coffee, chocolate contributes to the increase in oxalic acid salts. Also, magnesium deficiency in the body, vitamin deficiency B6, an excess of ascorbic acid can lead to oxalaturia.
However, malnutrition is not always the cause of increased oxalates. The following pathologies can provoke such a deviation:
- Diseases of the small intestine. Ailments such as Crohn’s disease, ulcerative colitis, and dysbiosis lead to the fact that oxalates are poorly filtered in the digestive tract and accumulate.
- Diabetes mellitus and gallstones. These pathologies are accompanied by metabolic disorders, which leads to oxalaturia.
- Ethylene glycol poisoning. When this substance is processed, oxalic acid is excreted in the body, which causes the appearance of an increased amount of oxalates in the urine.
- Primary hyperoxaluria. This is a genetic disease in which a person has a deficiency of enzymes that dissolve oxalic acid salts.
- Excess calcium. Excessive amounts of this element lead to an increase in oxalates.
Adverse factors can also be identified that exacerbate the course of oxalaturia. This dehydration, increased sweating, living in a hot and humid climate, drinking water with lots of mineral salts. Against the background of malnutrition, this can lead to the rapid growth of oxalaturia into urolithiasis.
Oxalaturia in children
Oxalates in the urine of a child under the age of 1 year are most often observed with genetic abnormalities. The cause of the pathology can be a congenital enzymatic disorder (primary hyperoxaluria). With this disease, the baby experiences a severe deviation in metabolism. The disease progresses and leads to the deposition of calcium in the kidneys and the formation of stones. Renal and vascular insufficiency and fragility of bones are noted.
In addition, another genetic disease, malabsorption syndrome, can cause oxalates in urine and infants. With this ailment, the absorption process in the gastrointestinal tract is disturbed, because of this, oxalate calcium accumulates in the body. Oxalaturia is also noted in congenital disorders of the anatomical structure of the small intestine.
In children over 6 years of age, oxalaturia is formed due to malnutrition, and it can also be provoked by the same pathologies as in adults (diabetes, gastrointestinal diseases, etc.)
Oxalaturia in pregnant women
Oxalates in the urine during pregnancy are rare. Usually during gestation, the amount of oxalic acid salts in the body is reduced. However, there are cases of oxalaturia in pregnant women. The following factors can provoke this violation:
- Fluid limitation. Often, pregnant women suffer from edema. For this reason, women try to drink as little water as possible. However, a lack of fluid can provoke an increase in oxalate in the urine.
- Wrong diet. During pregnancy, women try to eat as many vegetables and fruits as possible in order to fill the body with vitamins. However, an excess of such food can be harmful. Some plant foods are rich in oxalic acid. Excessive amounts of citrus, grapes, apricots, and plums in the diet can contribute to oxalaturia.
In addition, the cause of such a violation in pregnant women may be inflammatory diseases of the kidneys and bladder.
Oxalates and Urates
In the transcript of the analysis, an increased amount of urates and oxalates in the urine may be indicated. What do these results mean? Urates are salts of uric acid. Together with oxalates, these compounds are released in large quantities most often with improper nutrition. This happens if the patient eats too much protein food. Another reason for the high content of urates and oxalates may be foods rich in purines. These are offal, yeast, fish and seafood, cocoa, chocolate.
In addition, the cause of the increase in the number of oxalates and urates is dehydration. This is often noted in pathologies accompanied by vomiting and diarrhea. The level of salts of uric and oxalic acid increases with diseases of the kidneys and gout.
Oxalaturia and protein
Protein and oxalates in urine may appear after physical overstrain and hypothermia on the eve of urine testing. A similar analysis result is also possible with infectious inflammation: hepatitis, scarlet fever, osteomyelitis. If protein with oxalates is noted in pregnant women, then this is most often associated with gestational nephropathy.
Oxalates and white blood cells
Often, patients have elevated leukocytes and oxalates in the urine. What does it mean? Typically, such indicators indicate inflammatory diseases of the excretory organs. This may be a sign of pyelonephritis, cystitis, urethritis. White blood cells and oxalates are also increased with genital inflammation. In this case, mucus is detected in the urine.
Oxalates and phosphaturia
Phosphaturia is the excretion of urine phosphate compounds of magnesium, calcium or lime. Quite often, an increased amount of phosphates and oxalates in the urine is noted. What do these analysis results mean? Most often, this indicates the abuse of such foods as sea fish, dairy products, buckwheat and oatmeal dishes. These foods are rich in phosphorus.
The presence in the urine of an increased content of phosphates and oxalates can also be a manifestation of diseases of the parathyroid glands, diabetes mellitus, leukemia, and some mental pathologies. Oxalaturia in combination with phosphaturia in children under 5 to 6 years of age is most often associated with a lack of vitamin D (rickets).
Signs of pathology
At the early stage of the pathology, the presence of oxalates in the urine does not affect the well-being of a person. With a slight increase in calcium oxalate, this violation is asymptomatic.
Even at the stage of urolithiasis, pathology does not always make itself felt. Manifestations of the disease occur when acute oxalate stones appear in the urinary tract. This is characterized by the following symptoms:
- severe pain in the lower back and side (renal colic);
- pain in the lower abdomen;
- painful and frequent urination;
- coloring of urine in a pinkish, reddish or pink color due to an impurity of blood;
- nausea and vomiting;
- swelling of the eyelids after awakening;
- fever, chills.
It is important to remember that this condition is dangerous. With the appearance of blood in the urine and attacks of renal colic, it is urgent to seek medical help.
Treatment
With oxalaturia, medications with vitamin B6 and magnesium are prescribed: Pyridoxine hydrochloride, Asparkama, Magne B6. These medicines help remove oxalate salts. During the course of treatment, you need to monitor the level of hemoglobin, since magnesium can affect the iron content in the body.
To accelerate the excretion of salts, diuretic herbal preparations are also used: Urolesan, Uriflorin, Kanefron, Fitolizin.
To prevent the formation of stones, the drug "Cholestyramine" is prescribed. It reduces the absorption of oxalates and destroys existing deposits.
It is necessary to take drugs for a long time, since oxalates are difficult to dissolve and excrete.
Diet
Drug treatment must necessarily be supplemented by strict adherence to diet. Without a proper diet, it is impossible to achieve the effect of therapy. It is necessary to exclude the use of the following foods with a high content of oxalic acid:
- Leafy vegetables: sorrel, lettuce, celery, asparagus, spinach, rhubarb, parsnip.
- Some vegetables: potatoes, eggplant, tomatoes, beets.
- Fruit rich in oxalic acid: citrus fruits, apricots, plums.
- Red berries: strawberries, raspberries, currants.
- Coffee, cocoa and chocolate.
Animal proteins are also limited, these substances have a bad effect on the composition of urine. If oxalaturia is associated with intestinal diseases, then you should eat as little fatty foods as possible.
At the same time, the diet should include dishes rich in vitamin B6 and magnesium: wholemeal bread, bran, nuts, cereals, parsley.
Calcium in the diet should not be limited, this can lead to bone fragility. This element does not affect the formation of oxalates. Therefore, milk, kefir, yogurt and cottage cheese are not contraindicated.
During the day you need to drink from 2.5 to 3 liters of fluid. This will help to remove salts. It is useful to use mineral waters: Truskavetskaya, Donat Magnesium, Essentuki, Borjomi.
Prevention
To prevent oxalaturia, you need to eat right. Leafy vegetables, fruits and berries are necessary, as they saturate our body with vitamins. However, these healthy foods should be consumed in moderation to avoid kidney problems.
You need to try to move more and drink enough fluid (at least 1.5 liters per day). This helps to wash out all harmful salts and deposits from the body.
If a person has already detected an increased amount of oxalates, then it is necessary to regularly visit a urologist and take tests. Such patients are subject to dynamic observation. Constant medical monitoring will help to avoid the progression of the disease and the development of urolithiasis.