question: I am a 60 year old male. My doctor says my urinalysis
Should I express concern to my doctor about ‘crystals’ mentioned in urinalysis report as possibly caused by ethylene glycol (anti-freeze) exposure that might lead to kidney
failure? I have had right flank dull pain / ache / pressure in kidney area for over 1 year. MRI of kidneys shows parephrenic stranding and mild edema surrounding the kidneys. (both are signs of renal inflammation).
The research below says that low level exposure to ethylene glycol causes no neurologic symptoms, but low level (sub clinical) exposure over a long period would cause toxic damage to kidneys. A person could be exposed to ethylene glycol and be unaware of it, except for tell-tale crystals in the urine
: (see research excerpts below)
The urinalysis report says:
Crystals - Present Abnormal - Crystal Type Calcium Oxalate
Ketones - trace abnormal
Specific Gravity >=1.030 Abnormal
Microscopic blood cells (hematuria) have been seen in my urine twice over past year.
(see research excerpts below)
Ethylene glycol has long been recognized as a potentially lethal poison and remains available today as automotive antifreeze and windsheld deicer fluids. Ethylene glycol is rapidly absorbed from the gastrointestinal tract, with peak levels measured one to four hours after ingestion. Metabolism of the parent compound and the production of several organic acids are responsible for the metabolic acidosis observed in ethylene glycol poisoning. Target organ cellular damage is seen in the kidney, brain, myocardium, pancreas, and blood vessel walls. Renal tubular deposition of calcium oxalate crystals is felt to be responsible for the development of the severe renal injury which may accompany ethylene glycol ingestion. The clinical course is quite varied and includes inebriation, hematuria, cardiorespiratory compromise, and neurologic effects. Prompt diagnosis and initiation of treatment, including ethanol therapy and hemodialysis
Ethylene glycol is a colorless, odorless, sweet tasting, relatively non-volatile liquid and is completely soluble in water. This chemical has numerous uses, in manufacturing of polyethylene terephthalate, in natural gas processing, and as an antifreeze agent
The kidney is the critical organ for the toxicity of ethylene glycol (anti-freeze)
Neurobehavioral and neurological disorders have been reported in cases of acute ethylene glycol poisonings in humans.
In the limited number of investigations examined, neurological effects have not been observed at doses below those that have induced renal toxicity.
Monohydrate calcium oxalate crystals in the urine are an essential clue for diagnosis of ethylene glycol poisoning
Detection of calcium oxalate monohydrate crystals in the urine is the only real-time confirmation of the diagnosis.
In cases of ethylene glycol poisoning, calcium oxalate may be excreted not only as dihydrate crystals, but also as monohydrate crystals
Perinephric stranding refers to the appearance of oedema within the fat of the perirenal space on CT or MRI. While a degree of symmetric bilateral perinephric stranding is common, particularly in the elderly, asymmetric or unilateral perinephric stranding is an important sign of renal inflammation or of acute obstruction.