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Effects of Lactobacillus casei and Bifidobacterium breve on urinary oxalate excretion in nephrolithiasis patients


It had been suggested that lactic acid bacteria (LAB) may degrade oxalate in the intestinal lumen, reducing urinary oxalate excretion. We aimed to evaluate the effect of a LAB mixture containing Lactobacillus casei (LC) and Bifidobacterium breve (BB) (LC + BB) upon urinary oxalate reduction in stone-forming (SF) patients without hyperoxaluria under conditions of an oxalate-rich diet. After an oxalate restriction period (7 days washout), 14 SF patients consumed an oxalate-rich diet during 4 weeks (200 mg/day) and a lyophilized LC + BB preparation was given t.i.d. after meals during the last 2 weeks. Twenty-four-hour urine samples were collected for determination of oxalate, calcium, magnesium, citrate, sodium, potassium and creatinine at baseline, after 2 weeks (DIET) and 4 weeks (DIET + LC + BB). The mean urinary oxalate excretion was significantly higher after DIET versus baseline (27 ± 8 vs. 35 ± 11 mg/24 h), but the mean decrease was not significant between DIET + LC + BB and DIET periods (35 ± 11 vs. 33 ± 10 mg/24 h). Seven out of 14 patients presented a reduction in oxaluria after LC + BB versus DIET, being the reduction higher than 25% in 4, and up to 50% in 2 of them. The latter two patients were those who had presented the greatest increase in oxaluria in response to dietary oxalate. In conclusion, this mixture of L. casei and B. breve was shown to possess a variable lowering effect upon urinary oxalate excretion that may be dependent on dietary oxalate intake.

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This research was supported by grants from Coordenação de Aperfeiçoamento Pessoal de Nível Superior (CAPES) and Fundação Oswaldo Ramos - Hospital do Rim e Hipertensão. The authors wish to thank Janayna Morandini Pereira for technical assistance. We appreciate the support of Shinya Honda, Yasumi Ozawa Kimura and Julia Keiko Mukai from Yakult SA Indústria e Comércio (Brazil), who provided part of the funding for this trial, including the LAB preparation supply. The investigators were solely responsible for the design, conduct, analyses and publication of the trial. There have been no restrictions on publications and all data were maintained and analyzed solely by the authors.

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Correspondence to Ita Pfeferman Heilberg.

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Ferraz, R.R.N., Marques, N.C., Froeder, L. et al. Effects of Lactobacillus casei and Bifidobacterium breve on urinary oxalate excretion in nephrolithiasis patients. Urol Res 37, 95–100 (2009).

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  • Lactic acid bacteria
  • Lactobacillus casei
  • Bifidobacterium breve
  • Oxalate
  • Kidney stones