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Therapeutic effects of probiotics and herbal medications on oxalate nephrolithiasis: a mini systematic review.

  • 2024-02-01
  • Iranian journal of microbiology 16(1)
    • Hamed Taheri
    • Mohammad Mehdi Feizabadi
    • Reza Keikha
    • Rouhi Afkari

Background and objectives

The majority of all kidney stone cases are oxalate urolithiasis with a high risk of recurrence. Beside its widespread occurrence, kidney stones are characterized by severe complications and high treatment costs. Probiotics and herbal medications could be forthcoming therapeutic interventions in the management of oxalate kidney stones.

Materials and methods

The PubMed/MEDLINE database was searched for keywords "Oxalobacter formigenes" AND "Oxalate" OR "oxalate degradation" AND "Lactobacillus" OR "Bifidobacterium" OR "recombinant Lactobacillus" OR "Bacillus subtilis", and "urolithiasis" AND "herbal extract". The search returned 253 results, 38 of which were included in the review.

Results

Most of the oxalate-degrading probiotics belong to the Oxalobacter formigenes, Lactobacillus, Bifidobacterium, and Bacillus genus with a minimum dosage of 107 CFU in the form of capsules, sachets, and lyophilized powder. Oxalate concentration in media was 5-50mM with an incubation time ranging from 24h to 14 days. The majority of the studies suggested that probiotic supplementation might be useful for reducing urinary excretion of oxalate and urea and alleviation of stone formation. Different herbal extracts were used on murine models of nephrolithiasis (induced by 0.5-3% ethylene glycol) with reduction of renal inflammation and urinary parameters, and calcium oxalate crystals.

Conclusion

Several strains of probiotics and herbal extracts confer protective effects against kidney stone/nephrolithiasis, indicating their promising nature for being considered as elements of preventive / adjuvant therapeutic strategies.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus paracasei LPC09Reduced Kidney Stone FormationBeneficial
Moderate
Lactobacillus paracasei LPC09Reduced Renal InflammationBeneficial
Small
Lactobacillus paracasei LPC09Reduced Urinary Oxalate ExcretionBeneficial
Moderate
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