O. Formigenes Colonization in Calcium Oxalate Kidney Stone Disease

NCT ID: NCT06330246

Last Updated: 2025-05-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-17

Study Completion Date

2031-12-31

Brief Summary

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The goal of this trial is to test if colonization with the gut bacteria Oxalobacter formigenes leads to a reduction in urinary oxalate excretion in patients with calcium oxalate kidney stone disease.

The study will recruit adult participants with a history of calcium oxalate kidney stones who are not colonized with Oxalobacter formigenes.

Participants will

* ingest fixed diets containing low and moderately high amounts of oxalate for 4 days at a time
* collect urine, blood and stool samples during the fixed diets
* ingest a preparation of live Oxalobacter formigenes to induce colonization with Oxalobacter formigenes

Detailed Description

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In this study the investigators propose to measure the excretion of urinary oxalate on a fixed diet with controlled amounts of oxalate, before and after inducing colonization with the gut bacteria Oxalobacter formigenes in individuals with a history of calcium oxalate kidney stones not already colonized with Oxalobacter formigenes.

Screening and Pre-colonization phase. Between the University of Alabama at Birmingham (UAB) and the University of Texas Southwestern Medical Center (UTSW), the study will enroll 40 individuals with a history of idiopathic calcium oxalate kidney (20 males/20 females). Screening will include stool colonization testing, blood complete metabolic profile, 24-hr urine specimens collected at home on self-selected diets and anthropometric measurements.

Participants will ingest a low-oxalate (\<60 mg/day) fixed diet for 4 consecutive days and collect two 24-hr urines and a stool sample after 2 days of dietary equilibration, as well as one fasted blood sample on the last morning.

After a wash-out period of at least 1 week, participants will ingest a moderately high-oxalate (250-300 mg/day) fixed diet for 4 consecutive days and collect two 24-hr urines and a stool sample after 2 days of dietary equilibration, as well as one fasted blood sample on the last morning.

Colonization and Post-colonization phase. Participants will be colonized with Oxalobacter formigenes by ingesting a freshly thawed paste of live bacterial preparation of O. formigenes. They will collect a stool sample 1 week later to assess if colonization occured.

After confirmation of successful colonization, participants will ingest a low-oxalate (\<60 mg/day) fixed diet for 4 consecutive days and collect two 24-hr urines and a stool sample after 2 days of dietary equilibration, as well as one fasted blood sample on the last morning.

After a wash-out period of at least 1 week, participants will ingest a moderately high-oxalate (250-300 mg/day) fixed diet for 4 consecutive days and collect two 24-hr urines and a stool sample after 2 days of dietary equilibration, as well as one fasted blood sample on the last morning.

Follow-up phase Participants will be followed up every 6 months to assess sustainability of colonization, provide a stool sample and answer a simple questionnaire. A 24-hr urine collection will be requested once a year after colonization, on the same moderately high oxalate diet diet after 2 days of dietary equilibration.

Conditions

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Kidney Stone Kidney Calculi Urolithiasis Urolithiasis, Calcium Oxalate Nephrolithiasis Nephrolithiasis, Calcium Oxalate Oxalate Urolithiasis Oxaluria

Study Design

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Allocation Method

NA

Intervention Model

SEQUENTIAL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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colonization with Oxalobacter formigenes

Colonization with a live preparation of Oxalobacter formigenes, strain OxCC13.

Group Type EXPERIMENTAL

Low oxalate fixed diets pre-colonization

Intervention Type DIETARY_SUPPLEMENT

4 days of fixed eucaloric diet with low oxalate (\< 60 mg/day), normal calcium (600-1000 mg/day)

Moderately high oxalate fixed diets pre-colonization

Intervention Type DIETARY_SUPPLEMENT

4 days of fixed eucaloric diet with moderately high oxalate (250-300 mg/day), normal calcium (600-1000 mg/day)

Colonization with Oxalobacter formigenes

Intervention Type DIETARY_SUPPLEMENT

Ingestion of live Oxalobacter formigenes

Low oxalate fixed diets post-colonization

Intervention Type DIETARY_SUPPLEMENT

4 days of fixed eucaloric diet with low oxalate (\< 60 mg/day), normal calcium (600-1000 mg/day)

Moderately high oxalate fixed diets post-colonization

Intervention Type DIETARY_SUPPLEMENT

4 days of fixed eucaloric diet with moderately high oxalate (250-300 mg/day), normal calcium (600-1000 mg/day)

Interventions

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Low oxalate fixed diets pre-colonization

4 days of fixed eucaloric diet with low oxalate (\< 60 mg/day), normal calcium (600-1000 mg/day)

Intervention Type DIETARY_SUPPLEMENT

Moderately high oxalate fixed diets pre-colonization

4 days of fixed eucaloric diet with moderately high oxalate (250-300 mg/day), normal calcium (600-1000 mg/day)

Intervention Type DIETARY_SUPPLEMENT

Colonization with Oxalobacter formigenes

Ingestion of live Oxalobacter formigenes

Intervention Type DIETARY_SUPPLEMENT

Low oxalate fixed diets post-colonization

4 days of fixed eucaloric diet with low oxalate (\< 60 mg/day), normal calcium (600-1000 mg/day)

Intervention Type DIETARY_SUPPLEMENT

Moderately high oxalate fixed diets post-colonization

4 days of fixed eucaloric diet with moderately high oxalate (250-300 mg/day), normal calcium (600-1000 mg/day)

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* age 19-70 yrs
* Body Mass Index \> 18.5 kg/m2
* First time or recurrent Calcium Oxalate stone former. Composition of most recent stone ≥ 50% calcium oxalate if available
* Not colonized with Oxalobacter formigenes
* Normal fasting serum electrolytes on comprehensive metabolic profile
* Willing to ingest fixed diets
* Willing to stop supplements (vitamins including vitamin C, calcium (citrate or carbonate) and other minerals, herbal supplements, nutritional aids, probiotics) for 2 weeks before start and during fixed diet phases.
* If on medications for stone prevention (e.g. thiazides, citrate, allopurinol), stable dose regimen for at least 2 weeks prior to and during study

Exclusion Criteria

* Chronic Kidney Disease stage 4-5
* Primary hyperoxaluria
* Liver, endocrine or renal diseases (other than idiopathic Calcium Oxalate kidney stones) or any other condition that may influence the absorption, transport or urinary excretion of ions, which will compromise the interpretation of results, including: Cystic fibrosis, Cystinuria, Uric acid stone former, Nephrotic syndrome, Sarcoidosis, Renal tubular acidosis, Primary hyperparathyroidism, Neurogenic bladder, Urinary diversion
* Pregnancy or breast-feeding
* Incompatible dietary requirements with the study, food allergies or intolerance to any of the foods in study menus
* Active malignancy or treatment for malignancy within 12 months prior to screening
* Utilization of immunosuppressive medication
* Uncontrolled Hypertension or diabetes
* Diabetes type 1
* Current Colonization with Oxalobacter formigenes
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Texas Southwestern Medical Center

OTHER

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Alabama at Birmingham

OTHER

Sponsor Role lead

Responsible Party

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Sonia Fargue

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sonia Fargue, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Alabama at Birmingham

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status RECRUITING

UTSW

Dallas, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Sonia Fargue, PhD

Role: CONTACT

2059756932

Demond Wiley

Role: CONTACT

2059345712

Facility Contacts

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Sonia Fargue, PhD

Role: primary

205-975-6932

Research Coordinator

Role: backup

2059345712

Naim Maalouf, MD

Role: primary

Esperanza Jackson

Role: backup

Other Identifiers

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R01DK137784

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB300005280-OCK

Identifier Type: -

Identifier Source: org_study_id

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