Probiotic Intervention in the Management of Urolithiasis: A Pathway to Gut Microbiome Modulation

Urolithiasis, or kidney stone disease, is a chronic, recurrent disorder that significantly impacts renal health. Despite the availability of pharmacological and dietary strategies, recurrence of urolithiasis remains a major challenge. Emerging research highlights the gut–kidney axis as a critical mediator in kidney stone pathophysiology, particularly through its influence on oxalate metabolism. The gut microbiota plays a central role in this process, with dysbiosis contributing to hyperoxaluria and calcium oxalate stone formation. Conventional therapies often fail to correct the underlying dysbiosis, highlighting the need for microbiome‐targeted strategies. This review explores the potential of probiotic interventions as a microbiome‐targeted approach to reduce kidney stone recurrence. The key oxalate‐degrading bacterial strains including Oxalobacter formigenes , Lactobacillus , and Bifidobacterium spp. were reported to metabolize dietary oxalate, reduce intestinal absorption, and lower urinary oxalate excretion. Additionally, probiotics are recognized for their anti‐inflammatory effects and ability to restore gut eubiosis, offering indirect benefits in preventing stone formation. The review also discusses synbiotic, novel delivery systems (e.g., encapsulation and nanoformulations), and their integration with conventional therapies such as dietary modulation and pharmacological agents. Key challenges such as individual microbiome variability, strain‐specific efficacy, regulatory constraints, and limited clinical translation are critically evaluated. Moreover, the review highlights recent advances in multiomics technologies such as metagenomics and metabolomics that support the development of personalized probiotic therapies. By aligning with emerging concepts in microbiota and pathogen interactions and precision nutrition, this work underscores the therapeutic potential of microbiome‐targeted interventions in urolithiasis. Ultimately, leveraging gut microbiota modulation through probiotics may provide a safe, adjunctive strategy to reduce recurrence and enhance long‐term kidney health.