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Ausencia de Oxalobacter formigenes en pacientes con fibrosis quística: un factor de riesgo para la hiperoxaluria
Lancet (London, England)
|October 6, 1998
Resumen
Los pacientes con fibrosis quística que carecen de la bacteria intestinal Oxalobacter formigenes tienen un mayor riesgo de hiperoxaluria y cálculos renales. Esta ausencia, a menudo debido a los antibióticos, puede alterar permanentemente la flora intestinal y aumentar la absorción de oxalato.
Área de la Ciencia:
- Microbiología Microbiología.
- Nefrología Nefrología.
- Gastroenterología y Gastroenterología.
Sus antecedentes:
- Los pacientes con fibrosis quística (FC) se enfrentan a riesgos elevados de hiperoxaluria, nefrocalcinosis y urolitiasis por oxalato de calcio.
- La bacteria intestinal Oxalobacter formigenes juega un papel en la homeostasis del oxalato.
- La pérdida de O. formigenes está relacionada con el aumento de la hiperoxaluria y la formación de cálculos renales.
Objetivo del estudio:
- Investigar la correlación entre la ausencia de O. formigenes y la hiperoxaluria en pacientes con FQ.
- Para determinar si la colonización de O. formigenes difiere entre los pacientes con FQ y los individuos sanos.
Principales métodos:
- Se analizaron muestras de heces de 43 pacientes con FQ y 21 voluntarios sanos (de 3 a 9 años) para detectar O. formigenes a través de cultivos y análisis de ADN.
- Se recogieron muestras de orina de 24 horas para medir los niveles de oxalato y otros factores relacionados con las piedras.
Principales resultados:
- La colonización de O. formigenes fue significativamente menor en los pacientes con FQ (16%) en comparación con los voluntarios sanos (71%).
- 19 de 36 pacientes con FQ sin O. formigenes (53%) presentaron hiperoxaluria, con mayor gravedad en pacientes más jóvenes.
- Los pacientes con FQ colonizados con O. formigenes mostraron niveles normales de oxalato urinario.
Conclusiones:
- La ausencia de O. formigenes en pacientes con FQ se asocia con un aumento de la absorción de oxalato, lo que aumenta el riesgo de hiperoxaluria y complicaciones relacionadas.
- El uso prolongado de antibióticos y los cambios gastrointestinales relacionados con la FQ pueden causar la descolonización permanente de O. formigenes en pacientes con FQ.
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