Probiotics as a biotherapeutic approach for the management of kidney stone and its associated disorders

Calcium oxalates is one of the most prevalent stone among various stones formed in kidneys worldwide. The stone formation is directly linked to the dietary intake of oxalic acid and its complex formation with body calcium. The aim of the review is to point the potential of probiotics in the prevention and management of kidney stones by modulating gut-kidney axis. The article focuses on the multifaceted relationship between diet, microbial diversity of gut and oxalate metabolism. It talks about the mechanisms of kidney stone formation and degradation as well. Moreover it also elaborates on the importance of probiotic microbial strains and their enzymes to reduce intestinal absorption of oxalate along with the details of other important metabolic pathways implicated in the production of oxalate. The role of dietary precursors, including ascorbate and hydroxyproline are also discussed with reference to kidney stone formation. In addition to above, the effect of dietary calcium, short-chain fatty acids, exposure to antibiotics and gut dysbiosis are also considered to determine their role in the disruption of oxalate homeostasis and the promotion of stone formation. A summary of evidence in terms of in-vitro, in-vivo and clinical studies carried out in order to evaluate the therapeutic potential of probiotics in are also incorporated. These results imply that gut microbiota modulation can improve the oxalate metabolism and possess the potential to decrease the risk of kidney stones formation. In general, this review presents a full picture of the diet-gut-kidney axis and highlights the potential of probiotics as an effective strategy to prevent and manage kidney stone.