ICD-10: R82.992

Hyperoxaluria, classified under the ICD-10-CM code R82.992, refers to a condition characterized by an excessive amount of oxalate in the urine. This condition can lead to various health complications, particularly affecting the kidneys, as high levels of oxalate can contribute to the formation of kidney stones and may result in renal damage over time.

Clinical Description of Hyperoxaluria

Definition and Pathophysiology

Hyperoxaluria occurs when the body produces too much oxalate, a byproduct of certain metabolic processes. Oxalate is primarily derived from dietary sources, such as spinach, nuts, and chocolate, as well as from the metabolism of glyoxylate, which can be elevated in certain metabolic disorders. The kidneys are responsible for filtering oxalate from the blood, and when oxalate levels exceed the kidneys' ability to excrete it, hyperoxaluria develops[1][2].

Types of Hyperoxaluria

There are two main types of hyperoxaluria:

1. Primary Hyperoxaluria: This is a rare genetic disorder caused by enzyme deficiencies in the liver that lead to excessive oxalate production. It is often inherited in an autosomal recessive pattern and can result in severe kidney damage and systemic complications.

2. Secondary Hyperoxaluria: This form is more common and can occur due to dietary factors, malabsorption syndromes, or other conditions that increase oxalate absorption in the intestines. For instance, individuals with inflammatory bowel disease or those who have undergone intestinal bypass surgery may experience secondary hyperoxaluria[3].

Symptoms and Complications

Patients with hyperoxaluria may not exhibit symptoms initially, but as the condition progresses, they may experience:

• Kidney Stones: The most common complication, as oxalate can crystallize in the kidneys, leading to pain and urinary obstruction.
• Renal Failure: Chronic hyperoxaluria can lead to progressive kidney damage and eventual renal failure if not managed appropriately.
• Bone Disease: In severe cases, oxalate can deposit in bones, leading to osteopathy and other skeletal issues[4].

Diagnosis

Diagnosis of hyperoxaluria typically involves:

• Urine Tests: Measurement of oxalate levels in a 24-hour urine sample is the primary diagnostic tool.
• Blood Tests: Assessing kidney function and checking for elevated oxalate levels in the blood can also be informative.
• Imaging Studies: Ultrasound or CT scans may be used to identify kidney stones or assess kidney damage[5].

Management and Treatment

Management of hyperoxaluria focuses on reducing oxalate levels and preventing complications:

• Dietary Modifications: Patients are often advised to limit foods high in oxalate and increase fluid intake to dilute urine.
• Medications: Calcium supplements may be prescribed to bind oxalate in the gut, reducing its absorption.
• Surgical Interventions: In cases of severe kidney stones or renal failure, surgical options such as lithotripsy or nephrectomy may be necessary[6].

Conclusion

ICD-10 code R82.992 for hyperoxaluria encapsulates a significant clinical condition that requires careful diagnosis and management to prevent serious complications, particularly related to kidney health. Understanding the underlying causes, symptoms, and treatment options is crucial for healthcare providers in effectively managing patients with this condition. Regular monitoring and a multidisciplinary approach can help mitigate the risks associated with hyperoxaluria and improve patient outcomes.

Hyperoxaluria, classified under the ICD-10-CM code R82.992, is a condition characterized by elevated levels of oxalate in the urine. This condition can lead to various clinical manifestations and complications, particularly affecting the kidneys. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with hyperoxaluria.

Clinical Presentation

Definition and Causes

Hyperoxaluria occurs when there is an excess of oxalate in the urine, which can result from dietary factors, metabolic disorders, or increased intestinal absorption. The condition can be classified into primary and secondary hyperoxaluria:
- Primary Hyperoxaluria: A rare genetic disorder where the liver produces excessive oxalate due to enzyme deficiencies.
- Secondary Hyperoxaluria: Often results from dietary factors, malabsorption syndromes, or other underlying conditions that increase oxalate absorption.

Symptoms and Signs

Patients with hyperoxaluria may present with a variety of symptoms, which can include:

• Kidney Stones: The most common complication, as high oxalate levels can lead to the formation of calcium oxalate stones. Symptoms may include:
• Severe flank pain
• Hematuria (blood in urine)

• Nausea and vomiting

• Renal Failure: Chronic hyperoxaluria can lead to kidney damage and eventual renal failure, presenting with:

• Fatigue
• Swelling in the legs and ankles

• Decreased urine output

• Gastrointestinal Symptoms: In cases of secondary hyperoxaluria, patients may experience:

• Abdominal pain
• Diarrhea

• Weight loss due to malabsorption

• Other Symptoms: Some patients may also report:

• Frequent urination
• Urgency to urinate
• Painful urination

Patient Characteristics

Demographics

• Age: Hyperoxaluria can affect individuals of any age, but primary hyperoxaluria is often diagnosed in childhood or early adulthood.
• Gender: There is no significant gender predisposition, although some studies suggest a slightly higher incidence in males.

Risk Factors

• Diet: High intake of oxalate-rich foods (e.g., spinach, nuts, chocolate) can exacerbate symptoms, particularly in individuals with a predisposition to stone formation.
• Medical History: Conditions such as inflammatory bowel disease, gastric bypass surgery, or other malabsorption syndromes can increase the risk of secondary hyperoxaluria.
• Genetic Factors: Family history of primary hyperoxaluria can indicate a genetic predisposition.

Laboratory Findings

Diagnosis of hyperoxaluria typically involves:
- Urine Tests: Measurement of oxalate levels in a 24-hour urine collection is crucial for diagnosis.
- Blood Tests: May show elevated calcium levels or renal function impairment in chronic cases.

Conclusion

Hyperoxaluria, represented by the ICD-10 code R82.992, is a significant clinical condition that can lead to serious complications, particularly affecting renal health. Understanding the clinical presentation, symptoms, and patient characteristics is essential for timely diagnosis and management. Patients presenting with symptoms suggestive of hyperoxaluria should undergo appropriate laboratory evaluations to confirm the diagnosis and guide treatment strategies. Early intervention can help mitigate the risks of kidney stones and renal failure associated with this condition.

Hyperoxaluria, represented by the ICD-10-CM code R82.992, refers to a condition characterized by excessive oxalate in the urine, which can lead to kidney stones and other renal complications. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some alternative names and related terms associated with hyperoxaluria.

Alternative Names for Hyperoxaluria

1. Oxalate Nephropathy: This term is often used to describe kidney damage resulting from high levels of oxalate, which can be a consequence of hyperoxaluria.
2. Primary Hyperoxaluria: This refers to a genetic disorder that leads to the overproduction of oxalate, distinguishing it from secondary forms caused by dietary factors or other conditions.
3. Secondary Hyperoxaluria: This term is used when hyperoxaluria is a result of other underlying conditions, such as malabsorption syndromes or excessive dietary intake of oxalate.
4. Hyperoxalemia: While this term specifically refers to elevated oxalate levels in the blood, it is closely related to hyperoxaluria, as high blood oxalate levels often correlate with increased urinary oxalate excretion.

Related Terms

1. Kidney Stones: Hyperoxaluria is a significant risk factor for the formation of calcium oxalate stones, making this term relevant in discussions about the condition.
2. Renal Failure: Chronic hyperoxaluria can lead to renal impairment or failure, linking it to broader discussions about kidney health.
3. Urolithiasis: This term refers to the formation of stones in the urinary tract, which can be directly associated with hyperoxaluria.
4. Calcium Oxalate Crystals: The presence of these crystals in urine is a common finding in patients with hyperoxaluria and is often used in diagnostic evaluations.

Conclusion

Understanding the alternative names and related terms for hyperoxaluria, such as oxalate nephropathy and primary or secondary hyperoxaluria, is essential for accurate diagnosis and treatment. These terms not only facilitate better communication among healthcare providers but also enhance patient understanding of their condition. If you have further questions or need more specific information regarding hyperoxaluria, feel free to ask!

Hyperoxaluria, classified under ICD-10-CM code R82.992, refers to a condition characterized by excessive oxalate in the urine, which can lead to kidney stones and other renal complications. The diagnosis of hyperoxaluria typically involves several criteria and diagnostic methods to ensure accurate identification of the condition.

Diagnostic Criteria for Hyperoxaluria

1. Clinical Symptoms

• Patients may present with symptoms such as flank pain, hematuria (blood in urine), and recurrent urinary tract infections. These symptoms can prompt further investigation into the underlying causes of urinary abnormalities.

2. Urine Oxalate Measurement

• A 24-hour urine collection is the standard method for measuring oxalate levels. Elevated urinary oxalate excretion (greater than 40 mg per day) is a key indicator of hyperoxaluria. This test helps differentiate between primary and secondary forms of hyperoxaluria.

3. Assessment of Kidney Function

• Renal function tests, including serum creatinine and estimated glomerular filtration rate (eGFR), are essential to evaluate the impact of hyperoxaluria on kidney health. Impaired kidney function may indicate a more severe case of hyperoxaluria.

4. Dietary and Medical History

• A thorough review of the patient’s dietary habits and medical history is crucial. Certain dietary factors, such as high intake of oxalate-rich foods (e.g., spinach, nuts, and chocolate), can contribute to elevated oxalate levels. Additionally, conditions like inflammatory bowel disease or malabsorption syndromes can lead to secondary hyperoxaluria.

5. Imaging Studies

• Imaging techniques, such as ultrasound or CT scans, may be employed to identify kidney stones or other renal abnormalities associated with hyperoxaluria. The presence of calcium oxalate stones can further support the diagnosis.

6. Genetic Testing

• In cases of suspected primary hyperoxaluria, genetic testing may be conducted to identify mutations in genes associated with the condition, such as AGXT, GRHPR, or HOGA1. This is particularly relevant for patients with a family history of kidney stones or early-onset kidney disease.

Conclusion

The diagnosis of hyperoxaluria (ICD-10 code R82.992) is multifaceted, involving clinical evaluation, laboratory tests, dietary assessment, and imaging studies. Accurate diagnosis is essential for effective management and treatment, which may include dietary modifications, increased fluid intake, and in some cases, medications or surgical interventions to prevent complications such as kidney stones. If you suspect hyperoxaluria, it is advisable to consult a healthcare professional for a comprehensive evaluation and appropriate testing.

Hyperoxaluria, classified under ICD-10 code R82.992, refers to an elevated level of oxalate in the urine, which can lead to kidney stones and other renal complications. The management of hyperoxaluria typically involves a combination of dietary modifications, pharmacological interventions, and supportive care. Below is a detailed overview of standard treatment approaches for this condition.

Dietary Modifications

1. Oxalate-Restricted Diet

• Limit High-Oxalate Foods: Patients are often advised to reduce the intake of foods high in oxalate, such as spinach, rhubarb, beets, nuts, and chocolate. This dietary change can help lower urinary oxalate levels[1].
• Increase Calcium Intake: Consuming adequate calcium can help bind oxalate in the intestines, reducing its absorption. Dairy products and calcium-fortified foods are good sources[2].

2. Hydration

• Increase Fluid Intake: Adequate hydration is crucial to dilute urine and reduce the concentration of oxalate, thereby minimizing the risk of stone formation. Patients are typically encouraged to drink plenty of fluids, aiming for at least 2-3 liters per day[3].

Pharmacological Interventions

1. Potassium Citrate

• Alkalinization of Urine: Potassium citrate can help alkalinize the urine, which may reduce the crystallization of calcium oxalate stones. It also increases urinary citrate levels, which can inhibit stone formation[4].

2. Oxalate-Degrading Enzymes

• Enzyme Replacement Therapy: In cases of primary hyperoxaluria, enzyme replacement therapy with agents like ascorbate or specific oxalate-degrading enzymes may be considered to help reduce oxalate production[5].

3. Antibiotics

• Preventing Urinary Tract Infections: In some cases, prophylactic antibiotics may be prescribed to prevent urinary tract infections, which can exacerbate the condition[6].

Supportive Care

1. Regular Monitoring

• Urinary Oxalate Levels: Regular monitoring of urinary oxalate levels is essential to assess the effectiveness of dietary and pharmacological interventions. This helps in adjusting treatment plans as necessary[7].

2. Management of Kidney Stones

• Stone Removal Procedures: If kidney stones develop, procedures such as lithotripsy or surgical removal may be required. Preventive measures should be reinforced post-treatment to avoid recurrence[8].

Conclusion

The management of hyperoxaluria (ICD-10 code R82.992) is multifaceted, focusing on dietary changes, pharmacological treatments, and supportive care to prevent complications such as kidney stones. Patients should work closely with healthcare providers, including dietitians and nephrologists, to develop a personalized treatment plan that addresses their specific needs and conditions. Regular follow-ups and monitoring are crucial to ensure effective management and to adapt strategies as necessary.