Are the kidneys the primary pathway by which oxalate is removed from the body?
Yes, the kidneys are the primary pathway for oxalate removal from the body. The glomeruli filter oxalate and either excrete it directly in urine or secrete it by renal tubule cells. Around 90–95% of oxalate elimination occurs through the kidneys, while a small percentage is degraded by gut microbes or excreted via feces. If kidney function is impaired or overwhelmed, oxalate can accumulate in tissues, leading to conditions like oxalate nephropathy or systemic oxalosis. Maintaining proper hydration, electrolyte balance, and gut health supports oxalate clearance.
If kidney function is impaired or overwhelmed, where would oxalate accumulate?
If kidney function is impaired or overwhelmed, oxalate can accumulate in soft tissues throughout the body. Common sites include the renal parenchyma, bones, vascular walls, myocardium, retina, skin, and joints. In advanced cases, it may deposit in the thyroid, liver, lungs, spleen, and central nervous system. This widespread deposition—called systemic oxalosis—can cause inflammation, fibrosis, and organ dysfunction. The tissue preference often depends on local calcium concentrations and tissue perfusion, as oxalate forms poorly soluble calcium oxalate crystals, which trigger damage where they lodge.