What is Oxalobacter formigenes?

Oxalobacter formigenes is a bacterium that colonizes the colon of a substantial proportion of the normal population and metabolizes dietary and endogenous oxalate and hence reducing the incidence of kidney stones.

More about kidney stones:

Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. Kidney stones are common, affecting 1 in 11 people in the United States. The most common form of the condition is the calcium oxalate stone. Current treatments include dietary modification, medications, and surgical treatment. Dietary modifications include increasing fluids, increasing dietary calcium, and decreasing oxalate in the diet (e.g. spinach, rhubarb, potatoes, nuts), and avoiding high dose Vitamin C. Medications may be used to reduce calcium in the urine or to reduce uric acid levels.

Oxalate degradation by Oxalobacter formigenes is important for human health, helping to prevent hyperoxaluria and disorders such as the development of kidney stones.

Some antibiotics affect colonization with Oxalobacter formigenes.

Oxalate degradation by the anaerobic bacterium Oxalobacter formigenes is important for human health, helping to prevent hyperoxaluria and disorders such as the development of kidney stones.

-O. formigenes may be beneficial to host thyroid function by lowering circulating oxalate.

Low levels:

Studies suggest that the gut microbiome may play a role in calcium stone formation, and may therefore present a novel treatment approach. A low level of Oxalobacter formigenes has been identified as a risk factor for calcium oxalate stone formation.

O. formigenes breaks down oxalates in the gut, and if O. formigenes levels are low, oxalate levels can accumulate in the kidneys and potentially form calcium oxalate stones. The presence of O. formigenes is associated with a 70% reduction in the risk of recurrent kidney stones .

-Diminished O. formigenes colonization in the gut of urinary stone forming subjects was associated with reduced bone mineral density.

-Males carry O. formigenes at significantly lower abundance than females. This correlates with the higher kidney stone incidence in males compared to females.

Treatment options:

• A low oxalate diet: A diet low in oxalate is suggested to reduce urinary oxalate formation. Foods high in oxalate include: spinach, nuts/nut butters, beets, potatoes, rhubarb. Research suggests that dietary oxalate consumption must be reduced to 80 – 100 mg/day in order to be effective.
• Avoid calcium in supplement form: Calcium supplementation has been found to increase kidney stone risk. However, normal calcium intake through dietary sources did not, as this can help bind oxalates in the digestive tract.
• Recommend a low-fat diet: A low-fat diet is suggested to help limit the effects of bile acids on oxalate absorption in the colon.
• Avoid antibiotics to which O. formigenes is known to be sensitive, including: Azithromycin, Ciprofloxacin, Clarithromycin, Clindamycin, Doxycycline, , Gentamicin, Levofloxacin, Metronidazole, Tetracycline
• Check bone density: Diminished O. formigenes colonization in the gut of urinary stone forming subjects was associated with reduced bone mineral density.

References:

1. http://www.urologystone.com/CH18WhatsNew/2001AUA.html
2. https://www.ncbi.nlm.nih.gov/pubmed/24857648
3. https://www.ncbi.nlm.nih.gov/pubmed/23536130
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071521/
5. https://aem.asm.org/content/68/8/3841
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6151321/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571629/
8. https://www.ncbi.nlm.nih.gov/pubmed/12147479/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362665/
10. https://link.springer.com/article/10.1007%2Fs00203-016-1272-y
11. https://jasn.asnjournals.org/content/19/6/1197.long
12. https://www.tandfonline.com/doi/abs/10.3109/00365528009181482?journalCode=igas20

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