The altered composition of gut microbiota and biochemical features as well as dietary patterns in southern Chinese population with recurrent renal calcium oxalate stone

The correlation between gut microbiota, biochemical features and dietary patterns in recurrent stone formers have been limited investigated in Chinese population.42 patients with calcium oxalate stone (CaOxS group), including 34 recurrent stone formers (RS group), and 40 non-stone healthy subjects (NS group) from Changshu Hospital Affiliated to Soochow University were prospectively recruited. Food frequency questionnaires were completed for participants, fasting vein blood were extracted and 24h urine were collected for biochemical detection, fecal samples were gathered for 16S ribosomal RNA(rRNA) gene sequencing. BMI index, levels of serum triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), magnesium, creatinine and urine magnesium in stone formers were significantly different from controls, and RS patients showed significant low serum phosphate and high urine phosphate status. Celery, bamboo shoots and pickled food were the favored foods of the local stone formers. Patients with recurrent stones had altered composition of microbiota, with Escherichia, Fusobacterium and Epulopiscium being the predominant pathogenic genera. Gut microbiota in RS patients had stronger functions of fatty acid and amino acid degradation, but weaker in their biosynthesis.The pathogenic genera were positively correlated with BMI index, serum TG, creatinine, urine calcium, urine phosphate, urine uric acid (UA), celery, bamboo shoots and pickled food intake. Escherichia and Fusobacterium could predict stone recurrence in combination with serum magnesium and creatinine, with a sensitivity of 74% and specificity of 88%. Our research provided a novel prediction method and prevention strategy for the recurrence of renal calcium oxalate stone in the Han Chinese population in southern China.