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2017 ; 13
(7
): 1152-1157
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Oxalobacter formigenes colonization normalizes oxalate excretion in a gastric
bypass model of hyperoxaluria
#MMPMID28552742
Canales BK
; Hatch M
Surg Obes Relat Dis
2017[Jul]; 13
(7
): 1152-1157
PMID28552742
show ga
BACKGROUND: Hyperoxaluria and oxalate kidney stones frequently develop after
Roux-en-Y gastric bypass (RYGB). Oxalobacter formigenes can degrade ingested
oxalate. OBJECTIVES: Examine the effect of O. formigenes wild rat strain (OXWR)
colonization on urinary oxalate excretion and intestinal oxalate transport in a
hyperoxaluric RYGB model. SETTING: Basic Science Laboratory, United States.
METHODS: At 21 weeks of age, 28 obese male Sprague-Dawley rats survived Sham (n =
10) or RYGB (n = 18) surgery and were maintained on a 1.5% potassium oxalate, 40%
fat diet. At 12 weeks postoperatively, half the animals in each group were
gavaged with OXWR. At 16 weeks, percent dietary fat content was lowered to 10%.
Urine and stool were collected weekly to determine oxalate and colonization
status, respectively. At week 20, [14 C]-oxalate fluxes and electrical parameters
were measured in vitro across isolated distal colon and jejunal (Roux limb)
tissue mounted in Ussing Chambers. RESULTS: RYGB animals lost 22% total weight
while Shams gained 5%. On a moderate oxalate diet, urinary oxalate excretion was
4-fold higher in RYGB than Sham controls. OXWR colonization, obtained in all
gavaged animals, reduced urinary oxalate excretion 74% in RYGB and 39% in Sham
and was further augmented by lowering the percentage of dietary fat. Finally,
OXWR colonization significantly enhanced basal net colonic oxalate secretion in
both groups. CONCLUSIONS: In our model, OXWR lowered urinary oxalate by luminal
oxalate degradation in concert with promotion of enteric oxalate elimination.
Trials of O. formigenes colonization and low-fat diet are warranted in calcium
oxalate stone formers with gastric bypass and resistant hyperoxaluria.
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