Simultaneous use of oxalate-degrading bacteria and herbal extract to reduce the urinary oxalate in a rat model: A new strategy

ABSTRACT Objective: Urinary stones with oxalate composition can cause kidney failure. Recent findings evidenced that probiotics are effective in reducing oxalate absorption in these subjects based on their high colonic absorption levels at baseline. The purpose of this study was to evaluate the effect of the simultaneous use of oxalate-degrading bacteria, Urtica dioica and T. terrestris extract in reducing urinary oxalate. Materials and Methods: Anti-urolithiatic activity of Urtica dioica and T. terrestris extract and probiotic by using ethylene glycol induced rat model. In this study, 4 strains of Lactobacillus and 2 strains of Bifidobacterium and also 2 strains of L. paracasei (that showed high power in oxalate degrading in culture media) were used. Male Wistar rats were divided into four groups (n=6). The rats of group-I received normal diet (positive control group) and groups-II (negative control group), III, IV rats received diet containing ethylene glycol (3%) for 30 days. Groups III rats received Urtica dioica and T. terrestris extract. Groups IV rats received extracts + probiotic for 30 days. Findings: The results show that the use of herbal extracts (Urtica dioica and T. terrestris) reduced the level of urinary oxalate and other parameters of urine and serum. Also, the accumulation of calcium oxalate crystals in the kidney tissue was significantly reduced. Conclusion: Considering that the formation of calcium oxalate crystals can cause inflammation and tissue damage in the kidney, the use of herbal extracts with oxalate degrading bacteria can be a new therapeutic approach to preventing the formation of kidney stones.

Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention

ABSTRACT Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking. Objective: To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis. Materials and Methods: We studied 56 patients with kidney stones <10mm. Clinical, metabolic, and ultrasonography assessment was conducted before (baseline) the use of P. niruri infusion for 12-weeks (P. niruri) and after a 12-week (wash out) Statistical analysis included ANOVA for repeated measures and Tukey's/McNemar's test for categorical variables. Significance was set at 5%. Results: Mean age was 44±9.2 and BMI was 27.2±4.4kg/m2. Thirty-six patients (64%) were women. There were no significant changes in all periods for anthropometric and several serum measurements, including total blood count, creatinine, uric acid, sodium, potassium, calcium, urine volume and pH; a significant increase in urinary potassium from 50.5±20.4 to 56.2±21.8 mg/24-hour (p=0.017); magnesium/creatinine ratio 58±22.5 to 69.1±28.6mg/gCr24-hour (p=0.013) and potassium/creatinine ratio 39.3±15.1 to 51.3±34.7mg/gCr24-hour (p=0.008) from baseline to wash out. The kidney stones decreased from 3.2±2 to 2.0±2per patient (p<0.001). In hyperoxaluria patients, urinary oxalate reduced from 59.0±11.7 to 28.8±16.0mg/24-hour (p=0.0002), and in hyperuricosuria there was a decrease in urinary uric acid from 0.77±0.22 to 0.54±0.07mg/24-hour (p=0.0057). Conclusions: P.niruri intake is safe and does not cause significant adverse effects on serum metabolic parameters. It increases urinary excretion of magnesium and potassium caused a significant decrease in urinary oxalate and uric acid in patients with hyperoxaluria and hyperuricosuria. The consumption of P.niruri contributed to the elimination of urinary calculi.

Are patients with lichen planus really prone to urolithiasis? Lichen planus and urolithiasis

ABSTRACT Purpose to investigate whether patients with lichen planus (LP) are really prone to urolithiasis or not. Patients and Methods We performed a prospective analysis of 40 patients diagnosed with lichen planus (LP) (group I), and 40 volunteers did not have LP before (group II). Participants were all checked for urolithiasis by radiological investigations. Blood samples were analyzed for biochemistry parameters including calcium and uric acid. 24-h urine samples were analyzed to investigate oxalate, citrate calcium, uric acid, magnesium, sodium and creatinine. Results Men/women ratio and mean age were similar between group I and II (p>0.05). A presence or history of urolithiasis was detected in 8 (20%) and 2 (%5) patients in group I and II, respectively (p<0.05). Hypocitraturia was the most common anomaly with 35% (n:14) in group I. The rate of hypocitraturia in group II was 12.5% (n:5) and the difference was statistically significantly different (p=0.036). In group I, hyperuricosuria and hyperoxaluria followed with rates of 27.5% (n:11) and 25% (n:10), respectively. The rate of hyperuricosuria and hyperoxaluria were both 5% (n:2) in group II and the differences were significant (p<0.05). Hyperuricemia was another important finding in the patients with LP. It was detected in 13 (32.5%) patients in group I and in 1 (2.5%) participant in group II (p=0.001). Conclusion According to our results, metabolic disorders of urolithiasis were highly detected in the patients with LP. However, similar to the etiology of LP, the exact reasons for these metabolic abnormalities in LP remain a mystery.

Perfil de riesgo litogénico en pacientes con urolitiasis en Paraguay / Lithogenic risk in patients from Paraguay with urolithiasis

The lithogenic risk profile is a graphical representation of metabolic factors and urinary saturation involved in the stone formation with their respective critical values. Aim: To determine the lithogenic risk profile in patients with urolithiasis. Material and Methods: Personal data such as anthropometric, history of diseases and family history of urolithiasis were recorded. Different compounds acting as promoters or inhibitors of crystallization were measured in serum and urine samples, and the data obtained were used to calculate urinary saturation using Equil software. Results: We included 30 men and 43 women with a median age of 45 (34-54) years. Overweight and family history of urolithiasis was reported in 63 and 32% respectively. Crystallization risk was detected in 74% of participants. The most common urinary abnormalities were hypocitraturia in 48% and hypercalciuria in 40%. Conclusions: The lithogenic profile revealed urinary saturation compatible with crystallization risk in 74% of the studied patients.

Use of the probability of stone formation (PSF) score to assess stone forming risk and treatment response in a cohort of Brazilian stone formers

Introduction The aim was to confirm that PSF (probability of stone formation) changed appropriately following medical therapy on recurrent stone formers. Materials and Methods Data were collected on 26 Brazilian stone-formers. A baseline 24-hour urine collection was performed prior to treatment. Details of the medical treatment initiated for stone-disease were recorded. A PSF calculation was performed on the 24 hour urine sample using the 7 urinary parameters required: voided volume, oxalate, calcium, urate, pH, citrate and magnesium. A repeat 24-hour urine sample was performed for PSF calculation after treatment. Comparison was made between the PSF scores before and during treatment. Results At baseline, 20 of the 26 patients (77%) had a high PSF score (> 0.5). Of the 26 patients, 17 (65%) showed an overall reduction in their PSF profiles with a medical treatment regimen. Eleven patients (42%) changed from a high risk (PSF > 0.5) to a low risk (PSF < 0.5) and 6 patients reduced their risk score but did not change risk category. Six (23%) patients remained in a high risk category (> 0.5) during both assessments. Conclusions The PSF score reduced following medical treatment in the majority of patients in this cohort. .

Urinary oxalate, citrate, and gamma glutamyl transferase alterations after administration of Cynodon dactylon extract in cats

Urinary oxalate and citrate are the key factors in caox urolithiasis of cats and Gamma Glutamyl Transferase is a good test for assessment of kidney damage. Favorable effects of Cynodon dactylon on calcium oxalate stone formation have recently been proved in rats. The present study was designed to investigate the alteration of urinary oxalate, citrate, and GGT after administration of the hydroalcoholic extract of Cynodon dactylon to experimental hyperoxaluric cats. No scientific study has been done so far to demonstrate the beneficial effect of this plant in cats. 13 mature male cats were randomly divided into 3 groups: group A received standard diet and drinking water while, group B and C also received ethylene glycol at sub-toxic dose [130 mg/kg] daily for 30 days. Group C received hydroalcoholic extract of C.dactylon [400 mg/kg] from day 0 to 30, as well. Urine samples were collected on days 0, 15, and 30 and were analyzed for oxalate, citrate, and GGT levels. Urine oxalate level in group B was significantly higher than group C on days 15 and 30. Urinary citrate excretion was significantly higher in group C compared to the other groups on day 15; however, it decreased during the entire experiment in groups B and C. Urinary Gamma Glutamyl Transferase level was increased in hyperoxaluric cats and decreased in the treated group during the experiment. Based on our results, C.dactylon extract could reduce the hyperoxaluria and has beneficial effects on preventing the renal damage in cats. Such findings provide a scientific explanation for applying C.dactylon in prevention and possible treatment of CaOx kidney stones in cats and humans

Nephrocalcinosis induced by hyperoxaluria in rats

PURPOSE: To investigate nephrocalcinosis due to hyperoxaluria induced by two different inducing agents in rats. METHODS: Forty Sprague-Dawley male rats were randomly distributed into four groups: Group1 (Clinical control, n = 10); Group 2 (0.5% Ethylene Glycol + Vitamin D3, n = 10); Group 3 (1.25% Ethylene Glycol, n = 10); and Group 4 (5%Hydroxy L-proline, n = 10). Five animals from each group were euthanized after one week of follow-up (M1 Moment) and the remaining, after four weeks (M2 Moment). All animals underwent 24h urine dosages of calcium, oxalate, uric acid, citrate and serum creatinine. Histology and histomorphometric analyses were performed using Image J program in the hematoxylin-eosin stains. Calcium deposits in the renal parenchyma were quantified by PIXE technique (Proton Induced X-Ray Emission). RESULTS: 24h urinary parameters did not show any significant variations after 28 days of experiment except by hyperoxaluria that was significantly higher in Group 3. Histomorphometric analyses showed a significantly higher nephrocalcinosis in Group 2 (p<0.01). The calcium deposits in the renal parenchyma were 10 and 100 times higher in Group 2 in comparison to other groups in the M1 and M2 moments, respectively. CONCLUSION: The Group 2 (vitamin D3+Ethylene Glycol 0.5%) was the best model to induce nephrocalcinosis in rats after 28 days.

Effect of using strawberry juices supplemented with citrocid magnesium to minimize urinary oxalate in experimental rats

The suitability of two cultivars of strawberries namely Tamaroza and Chandler were used to prepare strawberry juices and supplemented with citrocid magnesium. Chemical analysis was carried out to determine moisture, total soluble solids, protein, titratable acidity, total sugars, crude fiber, oxalic acid, ash and minerals content. Results indicated that potassium was high and constituted the predominant mineral in the two tested strawberry cultivars. Oxalic acid was 82.72 and 86.73 mg/gm in fresh Tamaroza and Chandler, respectively. Meanwhile,supplementation of strawberry juices with 2,4 and 6% citrocid magnesium was effective in the reduction of oxalic acid content but supplementation with 2.0% was more effective in Tamaroza cultivars. Sensory evaluation indicated that Tamaroza juice supplemented with 2.0% citrocid magnesium had the highest score and came in the first order for color, taste, odor and general acceptability followed by Chandler strawberry juice compared to all other supplemented juices. On the other hand, biological evaluation was tested for rats fed on basal diet [control]; control plus 1.0 or 2.0 gm dehydrated Tamaroza strawberry [DTS]; control plus 1.0 or 2.0 gm dehydrated Chandler strawberry [DCS]. Feeding on diets containing 2.0 gm DTS supplemented with citrocid magnesium led to an increase in body weight of animals after 85 days. But, the highest ratio content of calcium was obtained for tibia bone of rats fed on basal diet mixed with 1.0 gm DCS. Results also indicated that the average decrement of femur calcium content was 9.45 to 12.53% as a result of feeding with DTS and DCS compared with control diet. Meanwhile, supplementation of dehydrated strawberry juices with citrocid magnesium was effective in improving the bioavailability of calcium and in reducing the oxalate content in rats serum and urine. Microscopic examination of urine ascertained that uric acid, amorphous materials and calcium oxalate were reduced or completely disappeared by continuous feeding of rats by DTS and DCS supplemented with citrocid magnesium till the end of the experiment [after 85 days]

Ethanolic extract of nigella sativa L seeds on ethylene glycol-induced kidney calculi in rats

The aim of this study was to investigate the effects of the ethanolic extract of Nigella Sativa L [NS] seeds on kidney calculi in rats. Thirty-two Wistar rats were randomly divided into 4 groups: group A received tap drinking water for 30 days [intact control]. Groups B, C, and D received 1% ethylene glycol for induction of calcium oxalate calculus formation. As the preventive, and treatment subjects, rats in groups C and D received ethanolic extract of NS, 250mg/kg, in drinking water since day 0 and day 14, respectively. Urine was collected on days 0, 7, 14, and 30 of the study period. After 30 days, the kidneys were removed and prepared for histologic evaluation of calcium oxalate deposits. Urine calcium oxalate concentrations were determined by atomic absorption. The number of CaOx deposits was significantly greater in group B [P=0.001]. Calcium oxalate concentrations in the urine on days 14 and 30 increased significantly in group B and were higher than those in group C [p=.006 and p=.002, respectively]. Urine oxalate concentration in group D decreased on day 30 and was lower than that in group B [P=.04]. Treatment of rats with ethanolic extract of NS reduced the number of calcium oxalate deposits in a group of rats that received ethanolic extract of NS. The NS could also lower the urine concentration of calcium oxalate. We suggest further studies on the therapeutic and preventive effects of the NS on kidney calculus formation in human

Changes in urinary compositions among children after consuming prepared oral doses of aloe (Aloe vera Linn).

OBJECTIVES: 1) To investigate the amount of citrate and tartrate in aloe gel, and in the urine of healthy normal children, before and after consuming fresh aloe gel. 2) To evaluate the changes in the chemical composition of urine among subjects after taking aloe gel. 3) To determine the value of consuming aloe gel for prevention of renal stone formation. DESIGN: Experimental study. MATERIAL AND METHOD: Thirteen healthy boys between 9 and 13 years of age were enrolled (with informed permission) in the clinical trial. Subjects ingested 100 g of fresh prepared aloe gel twice a day for seven consecutive days. The 24-hour urine was collected one day prior to taking the gel (Day 0), Days 2 and 5 of consumption, and Day 8 (one day after completion). The authors determined the urine volume, osmolality, potassium, sodium, phosphate, calcium, magnesium, uric acid, citrate, tartrate, oxalate, Permissible Increment in Calcium (PI Ca), Permissible Increment in Oxalate (PI Ox), Concentration Product Ratio of Calcium Phosphate (CPR CaPO4) and the citrate per creatinine ratio. RESULTS: The citrate and tartrate concentration in 100 g of fresh aloe gel was 96.3 and 158.9 mg, respectively. The 24-hr urine volume and urinary citrate excretion were significantly increased (p < 0.05). The PI Ca and the PI Ox were also significantly increased (p < 0.05). The other measurements were unremarkable. CONCLUSION: One hundred grams of fresh Aloe vera gel contains 96.3 milligrams of citrate and 158.9 milligrams of tartrate and were in the mid-range among Thai fruits. Changes in chemical compositions of urine after aloe gel consumption shows potential for preventing kidney stone formation among children.

Hypocitraturia in metabolically active calcium nephrolithiasis

Hypocitraturia is presumed to contribute to calcium stone formation. In this study, 52 patients with active calcium urolithiasis have been subjected to infrared spectrophotometric urolith analysis an collection of a 24-hour urinary sample for measurement of citrate, pH, calcium phosphorus, magnesium uric acid and oxalate. A venous blood sample was also taken for the measurement of calcium, potassium, uric acid, sodium phosphorus, carbon dioxide and creatinine levels. 93.3% of these patients had definite hypocitraturia, either as an isolated anomaly in 11.5% of patients or in association with hyperoxaluria and hyperuricosuria. When hypocitraturia was diagnosed more than half of the patients suffered from the severe form. Hypocitraturia in Egyptian metabolically active stone formers exceeds any known universal levels

role of urinary oxalate excretion in renal calculogenesis

The present study was undertaken with the aim to determine the role urinary oxalate excretion in renal lithiasis. The study was conducted on 60 renal calculus patients admitted in various Government Hospital of Lahore during the period from April to August 1996. Thirty normal subjects, with matched age and sex, were also included in this study, as a control group. Majority of the patients, 58 [97.7%], belonged to low and middle socio-economic classes. The mean daily excretion of oxalate in patients was significantly higher [P< 0.01] as compared to control group with a mean of 35.9 +/- 2.54 mg. moderate hyperoxaluria [24 hours oxalate excretion > 45 mg/day] was seen in significantly higher number of patients [25 out of 60], as compared to controls [5 out of 30]. The daily urinary oxalate was high in patients had pure calcium oxalate calcui and mixed calcium oxalate and uric acid calcui [with calcium oxalate as main component] as compared to patients with other renal calculi components. The ionic product of calcium oxalate was significantly higher [P< 0.01] in patients than controls. In the study the mean calcium excretion was 21.6% higher in the patients than the controls subjects, whereas oxalate excretion was 25% higher, which is statistically significant. These results suggest that increased oxalate excretion may be as important as increased calcium excretion in the aetiology of calcium oxalate calculus. The measurement of urinary oxalate and calcium is clearly useful in the management of calcium oxalate calculus formers

Electrokinetic energy conversion studies of urine-oxalic acid systems across urinary bladder membrane.

Electrokinetic studies of urine-oxalic acid systems with increasing concentration of oxalic acid in urine have been carried out across urinary bladder membranes. It has been found that electro-osmotic flux and streaming current decrease with increase in concentration of oxalic acid in urine while hydrodynamic flux and streaming potential increase with increase in concentration. Kinetic energy term (alpha 1) and polarizability term (alpha 2) have been computed for these systems and it has been found that polarizability decreases much faster with increase in concentration of oxalic acid in urine. Electrokinetic energy conversion of these systems have been computed and it has been found that electrokinetic energy conversion is maximum for urine and it decreases with increase in concentration of oxalic acid in urine. Poor energy conversion may lead to sluggish flushing action which may ultimately lead to formation of urinary calculi in the bladder and so present study may be of some use in predicting electrophysiology of the bladder.

Determinación cuantitativa de oxalato y citrato en orina por isotacofóresis analítica capilar / Quantitative determination of oxalate and citrate in urine by capillary analytical isotachophoresis

En la urolitiasis activa, la hiperoxaluria y la hipocitraturia son considerados factores importantes en la producción de los cálculos renales. La determinación cuantitativa de oxalato en orina, hasta el momento actual, presenta una gran diversidad de métodos y ninguno estable, la determinación cuantitativa de citrato resulta costosa por los métodos actualmente establecidos. Presentamos un método isotacoforético aniónico para la cuantificación de oxalato y citrato en orina de forma simultánea con detección conductimétrica y diferencial acopladas ambas sobre la base del comportamiento iónico de estos metabolitos en los fluídos biológicos

Electrokinetic energy conversion by aqueous oxalic acid, citric acid, ascorbic acid, hippuric acid, and acetyl salicylic acid across urinary bladder membranes.

Efficiency of energy conversion for electro-osmosis and streaming potential and the degree of coupling of acids across urinary bladder membranes of goat have been computed using non-equilibrium thermodynamic theory. The energy conversion maxima and degree of coupling for acids responsible for the formation of urinary calculi are found to be much low as compared to urea and urine.