Souradip Mallick, National Institute of Technology, Rourkela
Kidney stones affect approximately one in 11 individuals in their lifetimes, and their prevalence is increasing, some may develop chronic kidney disease and some end-stage renal disease. Still, pathophysiologic mechanisms of kidney stone formation remain incompletely characterized. It was believed that dietary patterns were mainly attributed to kidney stones. Recently it is observed that gut microbiome dysbiosis is linked to the pathophysiology of kidney stones. Although the bladder was previously considered to be “sterile” possessing its urinary microbiome was proved wrong with the application of 16S rRNA sequencing technology and the Expanded quantitative urine culture(EQUC) technique. The bladder urinary microbiome is related to urinary tract diseases like that of the gut microbiome affects human gut health. Dornbier et al. compared the upper and lower tract urine of kidney stone patients and observed there was no significant difference in the bacterial community between the upper and lower tract urine.
The urinary microbiome in the kidney pelvis after bladder disinfection and the same in the kidney pelvis was similar to that in the bladder urine. The urinary microbiome in the Stone kidney pelvis(SKP) samples was different from that in the Non-Stone kidney pelvis(NSKP) samples, which is due to alterations in Corynebacterium in the SKP samples. It is predicted that kidney stones can be improved by targeting modification of Corynebacterium; by dietary therapy. These findings might be because vesicoureteral reflux is common in patients with kidney stones, i.e., the possibility of bladder urine flowing back to the kidney pelvis increases, which may result in increased levels of shared microorganisms between SKP and bladder urine.
Bacterial genera in the bladder and kidney pelvis, includes Acinetobacter, Bifidobacterium, Corynebacterium, Lactobacillus, Staphylococcus, and Streptococcus, Delftia, Propionibacterium and Sphingomonas are dominant bacteria in patients with urinary stones.
It is also observed that bacterial profile in SKP was related to the clinical characteristics of the patients, indicating that changing these characteristics like fasting blood glucose and BMI, using microbiome-based therapy can control kidney stone occurrence. Lactobacillus was positively correlated with fasting blood glucose, and Prevotella was negatively correlated with BMI. Lactobacillus was significantly higher in SKP compared to blood but not in the case of NSKP compared to blood.
Thus, if the composition of the kidney pelvis urinary microbiome after disinfection of the bladder is similar to the bladder microbiome indicates that bladder urine can be used to replace kidney pelvis urine in microbiome research. Also, the comparison of SKP and NSKP indicates that the occurrence of kidney stones is responsible for the SKP urinary microbiome.
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[REFERENCE]- Fengping Liu, Nan Zhang, Yunhong Wu, Peng Jiang, Tingting Jiang, Yang Wang, Yuwei Zhang, Qixiao Zhai, Yeqing Zou & Ninghan Feng; BMC Microbiology, 336(2020); The pelvis urinary microbiome in patients with kidney stones and clinical associations https://doi.org/10.1186/s12866-020-01992-4
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