A rare cause of kidney disease and failure is oxalate nephropathy. It has multiple causes, including consuming high levels of oxalate, chronic pancreatitis, digestive conditions, and gastric bypass surgery.
Oxalate nephropathy is a rare cause of kidney failure. It happens when the levels of a chemical called calcium oxalate are too high, causing crystals to form in the kidneys. These crystals can cause damage and kidney failure.
Many reasons exist for why oxalate nephropathy occurs, and the type of treatment you might need depends on the exact cause.
This article will explore what this health issue is all about, what causes this, and how you might treat this depending on that cause.
Oxalates are chemical compounds found in many types of food, including vegetables, fruit, wheat-based foods, teas, and starches. Your body also makes oxalate as a digestive waste product.
Oxalate can be used as energy for many important body functions. For most people, oxalates aren’t a concern. In fact, eating foods that contain oxalates is typically highly recommended as part of a healthy diet.
However, sometimes oxalate levels can get too high and can cause serious damage to your kidneys.
High serum levels of oxalate can cause clumps, or crystals, of oxalate to form. As these calcium oxalate crystals pass through the body, they can damage the kidney and cause oxalate nephropathy.
The condition is rare, with a 2022 study finding that for about 3.6% of people with kidney disease, oxalate neuropathy was a primary or contributing cause.
Its effects on the kidney can be sudden and severe, and oxalate nephropathy can sometimes lead to kidney failure in just a few months.
Oxalate nephropathy might not cause any symptoms when it first develops.
It’s not uncommon for the first sign of oxalate nephropathy to be unusual results from routine bloodwork or bloodwork taken to monitor another condition.
When this happens, people who don’t have symptoms or any history of kidney health difficulties will have results that show their kidneys aren’t working as they should. For instance, results might show a high creatine level and a low glomerular filtration rate (GFR).
When oxalate nephropathy progresses, it can cause symptoms that overlap with other types of kidney damage or disease. This includes:
Although oxalate nephropathy is rare, it can be caused by a range of factors.
Sometimes oxalate nephropathy is the result of a genetic condition that causes your body to overproduce oxalates. This is typically called primary oxalate nephropathy.
However, it’s more common for oxalate nephropathy to be the result of another condition or of an external factor. This is called secondary oxalate nephropathy. Possible causes of secondary oxalate nephropathy include:
- Consuming high amounts of oxalate: It’s possible to take in too much oxalate. For instance, someone who takes vitamin C supplements and eats many foods high in vitamin C will also be consuming high levels of oxalate. In rare instances, this can lead to oxalate nephropathy.
- Chronic pancreatitis: Inflammation and damage to your pancreas can change the way your body absorbs fat. This can lead to oxalate nephropathy.
- Crohn’s disease and other digestive health conditions: Sometimes, the damage to your digestive tract caused by conditions such as Crohn’s disease can cause your body to have difficulty with oxalate.
- Roux-en-Y Gastric bypass surgery: Roux-en-Y is a type of gastric bypass surgery used to treat obesity and some types of stomach cancer. It can sometimes cause complications that change how your body processes and absorbs fats. As a result, oxalate nephropathy can develop.
- Ethylene glycol intoxication: Ethylene glycol is an alcohol found in products such as heavy-duty household cleaners and antifreeze. People sometimes ingest this alcohol accidentally and, in other cases, purposefully consume it as a replacement for standard alcohol or as a means of suicide. Ethylene glycol is toxic, and consumption can lead to oxalate nephropathy and other serious kidney damage.
Often, a large part of diagnosing oxalate nephropathy is ruling out other causes and forms of kidney disease. Oxalate nephropathy is rare.
You might have bloodwork, imaging, and other tests done to look for more common causes of kidney problems before oxalate nephropathy is considered. For instance, you might receive blood tests for hepatitis and HIV and imaging tests to look for tumors, cysts, or stones in your kidneys.
A urinalysis is also often performed. Sometimes, evidence of crystals or high levels of oxalate can be seen in urine samples. However, confirming a diagnosis of oxalate nephropathy typically requires a kidney biopsy.
The exact treatment for oxalate nephropathy will depend on the cause of the condition. For instance, when oxalate nephropathy is the result of consuming high levels of oxalate, dietary changes to eliminate the sources of excess oxalates are an important part of the treatment.
Other common treatments for oxalate nephropathy include:
Since oxalate nephropathy is rare, many additional treatments aren’t standard and have only been trialed a handful of times.
Some people with oxalate nephropathy respond well to other medications. This includes antiseizure medications that can lower overall oxalate levels or cholesterol-lowering medications that can help the body process fats.
Oxalate nephropathy is a rare cause of kidney disease and failure. Oxalates are naturally found in your body and in a wide variety of foods. They are typically not harmful, but sometimes, high levels of oxalates can cause crystals for form. These crystals can damage your kidneys and can lead to kidney failure.
There are multiple causes of oxalate nephropathy, including chronic pancreatic inflammation, gastric bypass surgery, ingesting high amounts of oxalate, ingesting ethylene glycol, and certain digestive disorders. Less commonly, oxalate nephropathy can be the result of a genetic condition.
Treatment of oxalate nephropathy depends on the cause but might include dietary changes, IV hydration, calcium and pancreatic enzyme supplements, and dialysis.