Oxalates in the urine of he althy people can be observed only in small quantities. An increase in these s alts most often indicates malnutrition, as they enter the body with food. Less commonly, oxalaturia is the result of intestinal pathologies, beriberi or hypervitaminosis and other diseases. If an increase in oxalate is found in the analysis of urine, then this is a harbinger of urolithiasis. Excessive amounts of these s alts can provoke 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 amenable to dissolution and fragmentation. Therefore, oxalaturia must be treated early, before it has progressed to severe urolithiasis.
What are oxalates
Oxalate crystals in urine are s alts of oxalic acid that enters the gastrointestinal tract from food. Then in the body, this compound interacts with calcium. going onchemical binding reaction. As a result, s alts are formed - calcium oxalates or calcium oxalate.
If s alts (oxalates) in the urine are observed in an increased amount for a long time, then over time they turn into stony deposits. These are quite dangerous formations in the kidneys. Oxalate stones have a rough texture 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 amount of oxalates, then you need to review your diet and undergo a course of therapy with a urologist.
Deciphering analysis and norm
These s alts can be detected by routine urinalysis. They are determined by microscopic examination of the urine sediment. The norm of oxalates in the urine in an adult is from 0 to 40 mg, and in a child - from 1 to 1.5 mg. If the amount of s alts goes beyond these limits, then we can talk about oxalaturia. However, urologists believe that oxalate levels above 25 mg already carry an increased risk of urolithiasis.
In deciphering a urine test for oxalates, a normal indicator of these s alts can be indicated as follows:
- up to 40 mg in 1 liter;
- small or moderate amount;
- two crosses "++".
At the same time, it is important to pay attention to other indicators of the analysis: the number of leukocytes, the presence of protein, urates and phosphates. The acidity (pH) of the urine should also be considered. Ata pH level of 5 to 7 oxalaturia is usually not noted. If the urine has excessive alkalinity or acidity, then oxalic acid s alts precipitate. In this case, there is an increase in oxalates.
Causes of high oxalate levels
The main cause of high levels of calcium oxalate in the urine is malnutrition. Most often this is due to the excessive consumption of products containing oxalic acid. These include:
- leaf crops (sorrel, asparagus, spinach, lettuce);
- tomatoes;
- citrus fruits;
- beets;
- legumes;
- berries;
- potato;
- beets.
Excessive consumption of tea, coffee, chocolate contributes to an increase in the level of oxalic acid s alts. Also, magnesium deficiency in the body, vitamin deficiency B6, excess ascorbic acid can lead to oxalaturia.
However, the cause of the increase in oxalates is not always malnutrition. The following pathologies can provoke such a deviation:
- Diseases of the small intestine. Diseases such as Crohn's disease, ulcerative colitis, dysbacteriosis, lead to the fact that oxalates are poorly filtered in the digestive tract and accumulate.
- Diabetes and gallstones. These pathologies are accompanied by a metabolic disorder, which leads to oxalaturia.
- Ethylene glycol poisoning. When this substance is processed in the body, oxalic acid is released, this causes an increased amount ofoxalates in urine.
- Primary hyperoxaluria. This is a genetic disease in which a person has a deficiency of enzymes that dissolve s alts of oxalic acid.
- Excess calcium. An excessive amount of this element leads to an increase in oxalates.
You can also identify adverse factors that aggravate the course of oxalaturia. This is dehydration, increased sweating, living in a hot and humid climate, drinking water with a lot of mineral s alts. Against the background of malnutrition, this can lead to the rapid development 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 may be a congenital enzymatic disorder (primary hyperoxaluria). With this disease, the baby has 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 bone fragility are noted.
In addition, another genetic disease, malabsorption syndrome, can cause oxalates in urine and babies. With this disease, the absorption process in the gastrointestinal tract is disrupted, because of this, calcium oxalate accumulates in the body. Oxalaturia is also noted in congenital disorders of the anatomical structure of the small intestine.
In children older than 6 years, oxalaturia is formed due to malnutrition, and it can also be provoked by the same pathologies as in adults (diabetes, gastrointestinal diseases, etc.).e.)
Oxalaturia in pregnant women
Oxalates in the urine during pregnancy are rare. Usually, during gestation, the amount of oxalic acid s alts in the body is reduced. However, there are cases of oxalaturia in pregnant women. The following factors can provoke this violation:
- Liquid limit. Often pregnant women suffer from edema. For this reason, women try to drink as little water as possible. However, lack of fluid can cause 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 types of plant foods are rich in oxalic acid. Excessive amounts of citrus fruits, grapes, apricots and plums in the diet can contribute to oxalaturia.
In addition, inflammatory diseases of the kidneys and bladder can be the cause of such a disorder in pregnant women.
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 s alts of uric acid. Together with oxalates, these compounds are excreted in large quantities, most often with malnutrition. This happens if the patient consumes too much protein food. Another reason for high levels of urates and oxalates can be food rich in purines. These are by-products, yeast, fish and seafood, cocoa, chocolate.
Besides this, the reasonan increase in the amount of oxalates and urates is dehydration of the body. This is often noted in pathologies accompanied by vomiting and diarrhea. The level of s alts of uric and oxalic acid increases with kidney disease and gout.
Oxalaturia and protein
Protein and oxalates in the urine may appear after physical overexertion and hypothermia on the eve of the study of urine. A similar result of the analysis is also possible with infectious inflammations: hepatitis, scarlet fever, osteomyelitis. If protein with oxalates is noted in pregnant women, then this is most often associated with gestational nephropathy.
Oxalates and leukocytes
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. Leukocytes and oxalates are also increased in inflammation of the genital organs. At the same time, mucus is found in the urine.
Oxalates and Phosphaturia
Phosphaturia is the excretion of phosphate compounds of magnesium, calcium or lime with urine. Quite often there is an increased amount of phosphates and oxalates in the urine. 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 of high levels of phosphates and oxalates in the urine can also be a manifestation of diseases of the parathyroid glands, diabetes mellitus, leukemia and some pathologies of the psyche. Oxalaturia combined withphosphaturia in children under 5 - 6 years of age is most often associated with a lack of vitamin D (rickets).
Signs of pathology
At an 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 disorder is asymptomatic.
Even at the stage of urolithiasis, pathology does not always make itself felt. Manifestations of the disease occur when sharp oxalate stones are in the urinary tract. It is characterized by the following symptoms:
- severe pain in the lumbar and side (renal colic);
- pain in the lower abdomen;
- painful and frequent urination;
- coloring urine pinkish, reddish or pink due to blood impurities;
- nausea and vomiting;
- eyelid swelling after waking up;
- fever, chills.
It is important to remember that this condition is dangerous. If blood appears in the urine and attacks of renal colic, you must urgently seek medical help.
Treatment
In case of oxalaturia, drugs with vitamin B6 and magnesium are prescribed: "Pyridoxine hydrochloride", "Asparkam", "Magne B6". These medicines help to remove oxalate s alts. During the course of treatment, you need to monitor the level of hemoglobin, as magnesium can affect the iron content in the body.
To speed up the removal of s alts, they are also useddiuretic herbal preparations: Urolesan, Uriflorin, Canephron, Phytolysin.
To prevent the formation of stones, the drug "Cholestyramine" is prescribed. It reduces the absorption of oxalates and destroys existing deposits.
It takes a long time to take drugs, as oxalates are difficult to dissolve and excrete.
Diet
Drug treatment must necessarily be supplemented by strict adherence to the diet. Without the right diet, it is impossible to achieve the effect of therapy. The following foods high in oxalic acid should be avoided:
- Leafy vegetables: sorrel, lettuce, celery, asparagus, spinach, rhubarb, parsnips.
- Some vegetable crops: potatoes, eggplants, tomatoes, beets.
- Fruits rich in oxalic acid: citrus fruits, apricots, plums.
- Red berries: strawberries, raspberries, currants.
- Coffee, cocoa and chocolate.
Also limit animal proteins, these substances have a bad effect on the composition of urine. If oxalaturia is associated with bowel disease, then you need to 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, it can lead to brittle bones. 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 remove the s alts. 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 he althy foods should be consumed in moderation to avoid kidney problems.
You need to try to move more and drink enough fluids (at least 1.5 liters per day). This helps to flush out all harmful s alts and deposits from the body.
If a person already has 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.
