4.3 Article

Gut microbiota and oxalate homeostasis

Journal

ANNALS OF TRANSLATIONAL MEDICINE
Volume 5, Issue 2, Pages -

Publisher

AME PUBL CO
DOI: 10.21037/atm.2016.12.70

Keywords

Bifidobacterium sp.; intestinal oxalate transport; lactobacillus sp.; Oxalobacter sp.; urinary oxalate excretion; small intestine; caecum; distal colon; hyperoxaluria; hyperoxalemia; urolithiasis

Funding

  1. National Institutes of Health [DK088892]

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This perspective focuses on how the gut microbiota can impact urinary oxalate excretion in the context of hyperoxaluria, a major risk factor in kidney stone disease. In the genetic disease of Primary Hyperoxaluria Type 1 (PH1), an increased endogenous production of oxalate, due to a deficiency of the liver enzyme alanine-glyoxylate aminotransferase (AGT), results in hyperoxaluria and oxalate kidney stones. The constant elevation in urinary oxalate in PH1 patients ultimately leads to tissue deposition of oxalate, renal failure and death and the only known cure for PH1 is a liver or liver-kidney transplant. The potential impact of a probiotic/therapeutic approach may be clinically significant in PH1 and could also extend to a much larger population of idiopathic oxalate stone formers who comprise similar to 12% of Americans, individuals with enteric hyperoxaluria, and an emerging population of hyperoxaluric patients who have undergone bariatric surgery and develop kidney stone disease as a consequence.

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