Hyperoxaluria and Oxalosis

Treatment

The treatment approach by Mayo Clinic takes into account each individual's needs, the type and severity of disease and how well the patient responds to treatment. The medical team at Mayo Clinic closely monitors patients to measure their responses to the following treatments:

• Medications
  All patients who may have primary hyperoxaluria receive prescription-level doses of pyridoxine (Vitamin B6). For many patients with Type 1 primary hyperoxaluria, this medication reduces the amount of oxalate produced by their liver. Neutral phosphates and citrate are also effective in reducing calcium oxalate crystals and stones in the urine.
• High fluid intake
  Hyperoxaluria patients who do not have kidney failure will need to increase the amount of water or other liquids they drink. The extra fluid is intended to keep the kidneys flushed, to help prevent the build up of oxalate and prevent formation of kidney stones.
• Dietary modifications
  Patients with acquired, absorptive or enteric hyperoxaluria will need to follow a diet low in oxalate. Those with enteric hyperoxaluria will also need to limit fat in their diet. Dietary restrictions are not as important in primary hyperoxaluria.

Kidney Stone Management

Large kidney stones that cause pain or other symptoms or are obstructing the flow of urine from the kidneys may require removal or fragmentation by lithotripsy (ESWL). A team of urologists, experienced in stone removal procedures, is available to recommend the best approach.

Kidney and Liver Transplant

Patients with primary and enteric forms of hyperoxaluria may eventually lose kidney function, depending on the severity of their disease, at what stage in the disease they are diagnosed and how well they respond to treatment. In some cases, patients with primary hyperoxaluria will first be diagnosed when their kidneys stop functioning (end-stage renal failure). For patients with kidney failure, treatment entails three approaches, based on each patient's disease characteristics and needs:

• Dialysis
  An artificial kidney machine is used to remove excess fluids and wastes from the body. However, this is only temporary, until a new kidney can be transplanted, since dialysis typically does not remove as much oxalate as is formed or absorbed each day. While on dialysis, most patients with primary hyperoxaluria will continue to build up oxalate in body tissues, thus developing oxalosis.
• Kidney Transplant
  A kidney transplant may be a good option for patients with Type I primary hyperoxaluria whose bodies produce less oxalate when taking Vitamin B6, and for most patients with Type II.
• Liver-kidney transplant
  For patients with Type 1 primary hyperoxaluria who do not sufficiently respond to Vitamin B6, a liver and kidney transplant is needed to cure their disease.

An experienced staff, high-quality facilities and a team approach to health care have earned Mayo Clinic's Transplant programs a premier reputation in organ transplantation.