Urinary oxalate levels and the enteric bacterium oxalobacter formigenes in patients with calcium oxalate urolithiasis

Cheol Kwak, Hee Kyung Kim, Eui Chong Kim, Myung Sik Choi, Hyeon Hoe Kim

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Objectives: We performed a prospective study to evaluate the intestinal colonization of Oxalobacter formigenes and its relationship with urinary oxalate levels in patients with calcium oxalate stone disease. Methods: One hundred and three patients with calcium oxalate urolithiasis, ranging in age from 21 to 73 years (mean age, 47 years) who were followed from August 2000 to September 2001 participated in this study. Fresh stool and 24-hour urine samples were collected. Genus specific oligonucleotide sequences corresponding to the homologous regions residing in the oxc gene were designed. In order to quantify O. formigenes in clinical specimens, a quantitative-PCR-based assay system utilizing a competitive DNA template as an internal standard was developed. Urine volume, pH, creatinine, oxalate, calcium, magnesium, phosphate, citrate and uric acid were measured. Results: Intestinal Oxalobacteria were detected in 45.6% (n = 47) of calcium oxalate stone patients by PCR. In stone formers who tested negative for Oxalobacteria, the average urinary oxalate level was 0.36 mmol/day, and this compared to 0.29 mmol/day for those patients that tested positive for Oxalobacteria (p < 0.05). Mean colony forming units per gram of stool of all patients was 1.1 × 107 (0-4.1 × 108), and the level of 24 hours urine oxalate significantly decreased with increasing level of colony forming units of O. formigenes (r = -0.356, p = 0.021). Conclusion: Our results support the concept that O. formigenes is important in maintaining oxalate homeostasis and that its absence from the gut may be the risk of calcium oxalate urolithiasis.

Original languageEnglish
Pages (from-to)475-481
Number of pages7
JournalEuropean Urology
Volume44
Issue number4
DOIs
StatePublished - 1 Oct 2003

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Oxalobacter formigenes
Oxalates
Enterobacteriaceae
Calcium Oxalate
Urine
Stem Cells
Polymerase Chain Reaction
Uric Acid
Oligonucleotides
Creatinine
Homeostasis
Calcium Oxalate Nephrolithiasis
Prospective Studies
DNA
Genes

Keywords

  • Oxalate
  • Oxalobacter formigenes
  • Urolithiasis

Cite this

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title = "Urinary oxalate levels and the enteric bacterium oxalobacter formigenes in patients with calcium oxalate urolithiasis",
abstract = "Objectives: We performed a prospective study to evaluate the intestinal colonization of Oxalobacter formigenes and its relationship with urinary oxalate levels in patients with calcium oxalate stone disease. Methods: One hundred and three patients with calcium oxalate urolithiasis, ranging in age from 21 to 73 years (mean age, 47 years) who were followed from August 2000 to September 2001 participated in this study. Fresh stool and 24-hour urine samples were collected. Genus specific oligonucleotide sequences corresponding to the homologous regions residing in the oxc gene were designed. In order to quantify O. formigenes in clinical specimens, a quantitative-PCR-based assay system utilizing a competitive DNA template as an internal standard was developed. Urine volume, pH, creatinine, oxalate, calcium, magnesium, phosphate, citrate and uric acid were measured. Results: Intestinal Oxalobacteria were detected in 45.6{\%} (n = 47) of calcium oxalate stone patients by PCR. In stone formers who tested negative for Oxalobacteria, the average urinary oxalate level was 0.36 mmol/day, and this compared to 0.29 mmol/day for those patients that tested positive for Oxalobacteria (p < 0.05). Mean colony forming units per gram of stool of all patients was 1.1 × 107 (0-4.1 × 108), and the level of 24 hours urine oxalate significantly decreased with increasing level of colony forming units of O. formigenes (r = -0.356, p = 0.021). Conclusion: Our results support the concept that O. formigenes is important in maintaining oxalate homeostasis and that its absence from the gut may be the risk of calcium oxalate urolithiasis.",
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Urinary oxalate levels and the enteric bacterium oxalobacter formigenes in patients with calcium oxalate urolithiasis. / Kwak, Cheol; Kim, Hee Kyung; Kim, Eui Chong; Choi, Myung Sik; Kim, Hyeon Hoe.

In: European Urology, Vol. 44, No. 4, 01.10.2003, p. 475-481.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Urinary oxalate levels and the enteric bacterium oxalobacter formigenes in patients with calcium oxalate urolithiasis

AU - Kwak, Cheol

AU - Kim, Hee Kyung

AU - Kim, Eui Chong

AU - Choi, Myung Sik

AU - Kim, Hyeon Hoe

PY - 2003/10/1

Y1 - 2003/10/1

N2 - Objectives: We performed a prospective study to evaluate the intestinal colonization of Oxalobacter formigenes and its relationship with urinary oxalate levels in patients with calcium oxalate stone disease. Methods: One hundred and three patients with calcium oxalate urolithiasis, ranging in age from 21 to 73 years (mean age, 47 years) who were followed from August 2000 to September 2001 participated in this study. Fresh stool and 24-hour urine samples were collected. Genus specific oligonucleotide sequences corresponding to the homologous regions residing in the oxc gene were designed. In order to quantify O. formigenes in clinical specimens, a quantitative-PCR-based assay system utilizing a competitive DNA template as an internal standard was developed. Urine volume, pH, creatinine, oxalate, calcium, magnesium, phosphate, citrate and uric acid were measured. Results: Intestinal Oxalobacteria were detected in 45.6% (n = 47) of calcium oxalate stone patients by PCR. In stone formers who tested negative for Oxalobacteria, the average urinary oxalate level was 0.36 mmol/day, and this compared to 0.29 mmol/day for those patients that tested positive for Oxalobacteria (p < 0.05). Mean colony forming units per gram of stool of all patients was 1.1 × 107 (0-4.1 × 108), and the level of 24 hours urine oxalate significantly decreased with increasing level of colony forming units of O. formigenes (r = -0.356, p = 0.021). Conclusion: Our results support the concept that O. formigenes is important in maintaining oxalate homeostasis and that its absence from the gut may be the risk of calcium oxalate urolithiasis.

AB - Objectives: We performed a prospective study to evaluate the intestinal colonization of Oxalobacter formigenes and its relationship with urinary oxalate levels in patients with calcium oxalate stone disease. Methods: One hundred and three patients with calcium oxalate urolithiasis, ranging in age from 21 to 73 years (mean age, 47 years) who were followed from August 2000 to September 2001 participated in this study. Fresh stool and 24-hour urine samples were collected. Genus specific oligonucleotide sequences corresponding to the homologous regions residing in the oxc gene were designed. In order to quantify O. formigenes in clinical specimens, a quantitative-PCR-based assay system utilizing a competitive DNA template as an internal standard was developed. Urine volume, pH, creatinine, oxalate, calcium, magnesium, phosphate, citrate and uric acid were measured. Results: Intestinal Oxalobacteria were detected in 45.6% (n = 47) of calcium oxalate stone patients by PCR. In stone formers who tested negative for Oxalobacteria, the average urinary oxalate level was 0.36 mmol/day, and this compared to 0.29 mmol/day for those patients that tested positive for Oxalobacteria (p < 0.05). Mean colony forming units per gram of stool of all patients was 1.1 × 107 (0-4.1 × 108), and the level of 24 hours urine oxalate significantly decreased with increasing level of colony forming units of O. formigenes (r = -0.356, p = 0.021). Conclusion: Our results support the concept that O. formigenes is important in maintaining oxalate homeostasis and that its absence from the gut may be the risk of calcium oxalate urolithiasis.

KW - Oxalate

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