Crystalluria, characterized by the presence of tiny crystals in urine, often goes unnoticed as it usually remains asymptomatic. However, these crystals can sometimes aggregate and form larger stones in the kidney, leading to pain, discomfort or urinary tract infections (UTIs). According to experts, signs like frequent urination, foul-smelling urine or pain while urinating can indicate the presence of crystals. Staying hydrated and making dietary adjustments can help prevent crystal formation, thereby reducing the risk of kidney stones.
Elevated concentration of minerals in the urine can cause the formation of crystals, says Dr Manohar Bhadrappa, consultant, urology and renal transplant surgery, Manipal Hospital, Bangalore. “Urine contains various dissolved substances, including waste products, salts and minerals. If the mineral levels are high, they can clump together and form solid crystals. These crystals are usually excreted if you drink enough fluids. In rare cases, however, medical intervention may be required,” he explains.
Crystals in urine: Should you be concerned?
Although crystalluria typically doesn’t show any symptoms, delayed diagnosis or intervention can lead to serious complications. Smaller crystals are usually harmless. However, when they aggregate or become large, they can block the ureter, which carries urine from the kidneys to the bladder. This can cause complications like blood in the urine, nausea, lower back pain, frequent urination, a burning sensation while urinating, pelvic pain, cloudy or foul-smelling urine, etc. One can also develop a fever in case of a UTI.
“Crystals in the urine can sometimes be an indicator of underlying infections or other conditions. If left unaddressed, it can eventually give rise to severe health problems like acute kidney injury, also known as acute renal failure,” explains Dr Ravish I R, lead consultant, urology, Aster RV Hospital, Bangalore.
Types of urine crystals
Crystals in the urine can be of different types, with varying shapes and sizes, says Dr Ravish. Their variety depends on the substances they are composed of. The main forms of urine crystals include:
♦ Struvite crystals: This type of urinary crystal is primarily composed of magnesium, ammonium and phosphate. They develop due to bacterial infections in the upper urinary tract, which make the urine more alkaline.
♦ Uric acid crystals: They form when there’s an elevated concentration of uric acid in the urine. As per research, common causes for the formation of such crystals include low urine volume, low urine pH (acidic urine) and metabolic syndrome, which makes one susceptible to cardiovascular conditions, diabetes and stroke. People with such crystals in their urine may also have gout — a condition caused by excess uric acid levels, causing pain and inflammation.
♦ Calcium oxalate crystals: These crystals are the most common cause of kidney stones. High levels of oxalate or low levels of urine can cause the oxalate to crystallize and form stones over time, says Dr Bhadrappa. Excessive consumption of oxalate-rich foods like spinach, nuts, chocolate, etc., can contribute to stone formation as well.
♦ Cystine crystals: These crystals can indicate cystinuria – a genetic disorder that causes excessive excretion of cysteine (an amino acid). This disorder makes one highly susceptible to developing kidney stones.
Decoding the manifestations of urine crystals
Determining whether the crystals indicate a UTI or a kidney stone depends on their respective manifestations. According to Dr Ravish, signs like lower abdominal pain (especially around the pubic area) or a burning sensation while urinating are common indications of UTIs, while kidney stones may cause pain in the back or around the side of the lower torso.
Diagnosis, treatment and prevention
A urine crystal test is usually part of a routine urinalysis, says Dr Bhadrappa. “The test analyzes the dissolved substances in the urine sample and can detect the type, size and number of crystals present in it,” he adds.
While small urine crystals can be addressed by ensuring adequate hydration to help expel them from the body, larger crystals that form stones over time require surgical intervention to break them apart or remove them, explains Dr Ravish.
Incorporating citric acid- and magnesium-rich foods like limes, tomatoes, pineapples, dry beans, wheat and whole grains into the diet while limiting the intake of vitamin C-rich ones can help prevent the formation of urine crystals. In addition, avoiding food items rich in oxalate and restricting protein intake are crucial, informs Dr Ravish.
Takeaways
- Crystalluria refers to the presence of crystals in the urine, often resulting from elevated mineral concentrations.
- While some crystals may be harmless, others can indicate underlying conditions like UTIs and kidney stones.
- The crystals can be of several types based on the substances they’re composed of. The primary forms include struvite, calcium oxalate and uric acid crystals.
- Drinking plenty of water can help expel the smaller crystals, while the larger ones that develop into stones require surgical intervention. Including citric acid- and magnesium-rich foods in the diet can help prevent crystal formation. On the other hand, avoiding oxalate-rich foods and limiting protein intake are also important.
