Phase 2
N=40
Use of Oral Probiotics to Reduce Urinary Oxalate Excretion
Nephrolithiasis · Hyperoxaluria · Crohn's Disease
Bottom Line
View on ClinicalTrials.gov: NCT00587041 ↗Enrolled (actual)
40
Serious AEs
0.0%
Results posted
May 2012
Primary outcome: Primary: Change in 24-hour Urinary Supersaturation for Calcium Oxalate — 1.40; 1.36; 1.42 KJoules/mol — p=0.3
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Oxadrop (Dietary_supplement); Agri-King Synbiotic (AKSB) (Dietary_supplement); Placebo (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Mayo Clinic
- Primary completion
- Jul 2009
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change in 24-hour Urinary Supersaturation for Calcium Oxalate |
1.40; 1.36; 1.42 | 0.3 |
| SECONDARY 24 Hour Urine Oxalate Excretion |
0.30; 0.31; 0.28 | — |
Summary
The purpose of this study was to determine the effect of two probiotic preparations (Agri-King Synbiotic and Oxadrop) on urinary oxalate excretion in patients with mild hyperoxaluria. Probiotics are live microorganisms thought to be beneficial to the host organism. Hyperoxaluria is a hereditary disorder that causes a special kind of stone to form in the kidney and urine. Oxalates are naturally-occurring substances found in plants, animals, and in humans. Excretion of oxalates in the urine is a risk factor for kidney stone formation.
Our hypothesis was that the mild hyperoxaluria is due to over absorption of oxalate from food and that probiotics will improve gastrointestinal barrier function to decrease oxalate absorption across the gut (and hence its elimination in the urine).
In the study, participants were randomized to placebo, Agri-King Synbiotic, or Oxadrop, and were treated for 6 weeks. Patients were maintained on a controlled diet to remove the confounding variable of differing oxalate intake and availability from food.
Eligibility Criteria
Inclusion Criteria
- Enteric hyperoxaluria (>0.5 mM/day; > 45 mg/day) due to fat malabsorption from inflammatory bowel disease (Crohn's Disease). (Patients in remission maintained on stable doses of Remicade/Imuran/Methotrexate every 8 weeks can be recruited as long as the trial can be conducted between 5 and 8 weeks after the last dose); OR
- Enteric hyperoxaluria (>0.5 mM/day; > 45 mg/day) from gastric bypass procedures (gastric bypass for obesity, or other surgical causes of gastric dumping and fat malabsorption (e.g., antrectomy, vagotomy and pyloroplasty for gastric ulcers) (Patients with inflammatory bowel disease must be in clinical remission); OR
- Calcium oxalate nephrolithiasis and mild hyperoxaluria of unknown etiology (>0.35 mM/day) (n=60)
- Presence of radioopaque stones on x-ray, or a history consistent with passage of a stone or stone surgery or extracorporeal shock wave lithotripsy (ESWL) in the last 5 years and if on stone medication, doses have remained stable for at least 3 months
- Stone composition confirmed either by stone analysis demonstrating composition equal to or more than 50% calcium oxalate, or by radiographic demonstration of a calcific renal stone in the presence of hyperoxaluria
Exclusion Criteria
- On immunosuppressive medications (excluding small stable doses of prednisone of 10 mg or less)
- Human immunodeficiency virus (HIV) infection, known enteric bacterial infection, or history of splenectomy
- Have a current malignancy, other than superficial skin cancers that have been excised, unless they felt to be in complete remission (> 5 years)
- Previous colectomy
- Have completed a course of oral or parenteral antibiotics less than 2 weeks before initiation of the study (patients who require a course of antibiotics during the period of preparation administration will be withdrawn from the study and excluded from the final analysis)
- Patient pregnant or breast-feeding
Data sourced from ClinicalTrials.gov (NCT00587041). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.