Kidney Stone Risk of Recurrence: Determine Oxalic Acid-degrading Bacteria

Oxalic acid/Oxalate containing kidney stones are among the most common kidney stones. In about 46 percent of hyperoxaluria patients, however, there are no reasons for the high oxalate burden. After therapy, recurrences occur in a quarter of nephrolithiasis patients.
The reason may be a disturbed oxalate homeostasis, due to the absence of the intestinal bacterium Oxalobacter formigenes

Oxalobacter formigenes specializes in what human metabolism can not do: it breaks down oxalate. The intestinal bacterium lives exclusively on oxalate and does not only rely on the oxalate we absorb with food. Oxalobacter formigenes additionally stimulates oxalate secretion from the intestinal epithelium into the lumen. For this, the bacterium secretes a protein that stimulates the oxalate transporter in the intestinal epithelium. Thus, Oxalobacter formigenes gives itself additional food and the body excretes significantly less oxalate in the urine. This reduces the oxalate burden on the kidneys.

Other intestinal bacteria such as lactobacilli can break down oxalate. However, they do not live off it, but take over the mining under certain conditions and use their detoxification metabolism.

If excessive oxalate accumulates in the body, this not only promotes the formation of kidney stones. It also favours diseases such as joint effusion, arthralgia and breast cancer.

Our new diagnostics Risk assessment of kidney stone recurrence shows the oxalate degradation and secretion capacity in the intestine on the detection of Oxalobacter formigenes and lactobacilli. If Oxalobacter formigenes is missing in the intestine or if the bacterium is only present in small numbers of cells, it can be counteracted dietary. At the same time, it is important to prevent an excessive influx of oxalate into the intestinal epithelium - for example, in a leaky gut - therapeutically.

Special attention is paid in the context of the vegetarians. Because the intestinal oxalate absorption and excretion of oxalate via the urine increase in a vegetarian diet regardless of their oxalate content.