Gut microbiota and the prevalence and incidence of renal stones

Han-Na Kim,Young-Sam Cho,Heung Jae Park,Yoosoo Chang,Jae Heon Kim,Seungho Ryu,Kwan Joong Joo,Dongmin Yang,Hyung-Lae Kim

doi:10.1038/s41598-022-07796-y

Abstract

The role of the gut microbiome in the development of renal stone diseases has not been well characterized. This study focused on the taxonomic and functional profiles of gut microbiomes according to the prevalence and incidence of nephrolithiasis. Stool samples from 915 Korean adults were collected at baseline. Participants were followed for a median of 4.0 years. We evaluated the biodiversity of the gut microbiota and taxonomic profiles associated with nephrolithiasis status, using 16S rRNA gene sequencing. Nephrolithiasis status was categorized into three groups: control (no-stone at both baseline and follow-up visits), incidental nephrolithiasis, and prevalent nephrolithiasis. Compared to the control and incidental nephrolithiasis, the prevalent nephrolithiasis showed a reduced evenness in alpha diversity. Nephrolithiasis was associated with a reduced abundance of some key taxa involved in short-chain fatty acid production. Moreover, the abundance of Bifidobacterium, which possess oxalate-degrading ability, was higher in the control. Conversely, there was no significant difference in the bacterial composition between the incidental and prevalent nephrolithiasis. In our study with repeated nephrolithiasis measurements, prevalent renal stones were associated with an altered gut microbiota composition compared to the control. Besides the known oxalate degradation pathway, other functional pathways inferred in this study require further investigation.

Highlights

The role of the gut microbiome in the development of renal stone diseases has not been well characterized
Research on this topic has mainly focused on Oxalobacter formigenes that utilizes oxalate as a principal energy substrate[9]
There were no significant differences in morbidities, including diabetes, obesity, metabolic syndrome, and nutritional intake (Supplementary Table S1) among the three groups

Summary

Introduction

The role of the gut microbiome in the development of renal stone diseases has not been well characterized. In our study with repeated nephrolithiasis measurements, prevalent renal stones were associated with an altered gut microbiota composition compared to the control. Gastrointestinal microbiota has been suggested to play a role in oxalate metabolism, one of major proportion of nephrolithiasis, possibly by affecting the intestinal absorption of oxalate and renal stone formation[6–8] Research on this topic has mainly focused on Oxalobacter formigenes that utilizes oxalate as a principal energy substrate[9]. Only five human studies, which have shown inconsistent findings, have evaluated the association between nephrolithiasis and the gastrointestinal m icrobiome[10–14] All five of these studies included patients with symptomatic renal stone disease and were limited by small sample sizes and cross-sectional associations with single-time measurements. The present study aimed to examine the association between the prevalence and incidence of renal stones and the gut microbiota in a relatively large-scale study of 915 participants

Methods

Results

Conclusion