Abstract
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.
Keywords
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Article info
Publication history
Published online: March 23, 2017
Accepted:
March 13,
2017
Received:
January 27,
2017
Identification
Copyright
© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
