International Urology and Nephrology (2018) 50:1189 https://doi.org/10.1007/s11255-018-1848-3 NEPHROLOGY - LE T TER TO THE EDITOR The importance of Oxalobacter formigenes and oxalic acid in the pathogenesis of chronic kidney disease 1 1 Ismail Baloglu · Kultigin Turkmen Received: 24 February 2018 / Accepted: 12 March 2018 / Published online: 19 March 2018 © Springer Science+Business Media B.V., part of Springer Nature 2018 Editor, Therefore, replacement of O. formigenes with probiotics such as natural products might decrease serum oxalic acid We read with great interest the recent publication ‘Gut levels and improve CKD-associated complications. We hope microbiota and chronic kidney disease: implications for that the previously mentioned comments might add to the novel mechanistic insights and therapeutic strategies’ by value of the manuscript by Pan et al. Pan et al. . Authors remarked that the intestinal micro- biota plays a key role in the pathogenesis of chronic kidney Compliance with ethical standards disease (CKD) and CKD-associated complications. In our Conflict of interest The authors declare no conflict of interest. opinion, some additional data can be added to the pathogen- esis of CKD regarding gut and renal axis. Human and animal rights This article does not contain any unethical In 1980s oxalic acid was found to be another exog- studies with human participants or animals performed by any of the enous cardiotoxic uremic retention molecule that cannot authors. be removed effectively via hemodialysis [ 2]. Oxalobacter formigenes (O. formigenes) has important roles in oxalate homeostasis by providing both reduction and secretion . References Recently, Turkmen et al.  hypothesized that serum oxalic acid degradation is impaired mainly due to decreased O. for- 1. Pan Wei, Kang Yongbo (2018) Gut microbiota and chronic kidney migenes colonization in hemodialysis patients and increased disease: implications for novel mechanistic insights and therapeu- tic strategies. Int Urol Nephrol 50:289–299 oxalic acid levels might be responsible for increased cardio- 2. Mydlik M, Derzsiova K (2010) Oxalic acid—important uremic vascular outcomes in CKD patients. In this regard, our group toxin. Vnitr Lek 56:695–701 showed that the colonization of O. formigenes was extremely 3. Kelly JP, Curhan GC, Cave DR, Anderson TE, Kaufman DW low in HD patients and furthermore we found a positive (2011) Factors related to colonization with Oxalobacter formi- genes in U.S. adults. J Endourol 25:673–679 correlation between serum oxalic acid levels and pulse wave 4. Turkmen K, Erdur FM (2015) The relationship between coloniza- velocity, central aortic systolic/diastolic blood pressures in tion of Oxalobacter formigenes serum oxalic acid and endothe- this population . These changes might be related to the lial dysfunction in hemodialysis patients: from impaired colon to decreased consumption of dietary fiber, delayed colonic impaired endothelium. Med Hypotheses 84(3):273–275 5. Gulhan B, Turkmen K, Aydin M, Gunay M, Cıkman A, Kara M transit times, chronic constipation, and impairment of pro- (2015) The relationship between serum oxalic acid, central hemo- tein assimilation in the small intestine secondary to the ure- dynamic parameters and colonization by oxalobacter formigenes mic milieu in CKD patients . In this context, we also in hemodialysis patients. Cardiorenal Med 5(3):164–174 hypothesized that the reduction in serum oxalic acid levels 6. Kalantar-Zadeh K, Kopple JD, Deepak S, Block D, Block G (2002) Food intake characteristics of hemodialysis patients as can improve cardiovascular outcomes in HD patients . obtained by food frequency questionnaire. J Ren Nutr 12:17–31 * Ismail Baloglu firstname.lastname@example.org Department of Internal Medicine, Division of Nephrology, Necmettin Erbakan University, Konya, Turkey Vol.:(0123456789) 1 3
International Urology and Nephrology – Springer Journals
Published: Mar 19, 2018
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