Current update and future directions on gut microbiome and nephrolithiasis.

Area of Science:

• Nephrology
• Microbiology
• Gastroenterology

Background:

• Nephrolithiasis incidence is rising globally.
• Gut microbiome's role in oxalate homeostasis is crucial for prevention strategies.
• Understanding the gut microbiome-nephrolithiasis link is essential.

Purpose of the Study:

• To review evidence on gut microbiome, hyperoxaluria, and nephrolithiasis.
• To identify microbiome-focused therapies for reducing hyperoxaluria and preventing kidney stones.
• To assess the efficacy of interventions like Oxalobacter formigenes and lactobacilli.

Main Methods:

• Literature review of studies on gut microbiome, hyperoxaluria, and nephrolithiasis.
• Analysis of animal and human studies on microbial interventions.
• Evaluation of antibiotic exposure and fecal transplantation impacts.

Main Results:

• Oxalobacter formigenes (Oxf) can degrade oxalate; animal studies show promise, but human results are inconsistent.
• Lactobacilli supplementation did not reduce hyperoxaluria.
• Antibiotic exposure is linked to increased nephrolithiasis risk.
• Fecal transplantation shows potential but requires clinical validation.

Conclusions:

• A link exists between gut microbiome and nephrolithiasis.
• Microbiome modulation strategies for hyperoxaluria and nephrolithiasis prevention require further investigation.
• Judicious antibiotic use may prevent nephrolithiasis in susceptible individuals.