The Use of Probiotic Bacteria to Treat Recurrent Calcium Oxalate Kidney Stone Disease

  • Brian R. Kullin
  • Sharon J. Reid
  • Valerie R. AbrattEmail author


Calcium oxalate-based kidney stones are the most common type found amongst idiopathic stone-forming patients. Excess dietary oxalate can be excreted via the faeces as well as the urine, and consumption of oxalate degrading probiotic bacteria might assist in reducing hyperoxaluria by degrading dietary oxalate in the gastrointestinal tract (GIT) before it can be absorbed. This chapter describes the genetic and in vitro aspects of microbial oxalate metabolism, and reviews in vivo trials involving the use of specific probiotic bacteria. Recent novel approaches using ingested purified oxalate degrading enzymes or in vivo expression of recombinant enzymes to reduce hyperoxalauria are also discussed.

In vitro studies have shown that certain Lactobacillus and Bifidobacterium species may have great potential for use as oxalate degrading probiotics since they reduce oxalate but can also survive in the gut under conditions where oxalate is limited. Gut colonisation and in vivo bacterial oxalate utilization studies in humans have shown a similar trend towards reducing oxalate levels. However, most of these interventions have been limited in their scope and need more rigorous investigation to measure their therapeutic value. A recent alternative approach used known amounts of in vitro purified recombinant oxalate decarboxylase enzyme to treat hyperoxaluria in animal models. These showed urinary oxalate degradation and low toxicity. Rats colonised with Lactobacillus plantarum expressing this recombinant enzyme also showed a significant reduction in urinary oxalate. The approaches reviewed here show potential therapeutic value in vitro, but all require extensive further evaluation in well-designed human trials.


Urinary Oxalate Urinary Oxalate Excretion Lactic Acid Bacterium Species Kidney Stone Disease Probiotic Preparation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Brian R. Kullin
    • 1
  • Sharon J. Reid
    • 1
  • Valerie R. Abratt
    • 1
    Email author
  1. 1.Molecular and Cell BiologyUniversity of Cape TownRondebosch Cape TownSouth Africa

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