Association of Akkermansia muciniphila with Clinical and Metabolic Characteristics of Patients with Urolithiasis and Its Potential for Recurrence Prevention
Year: 2026
Type: article
Abstract: Background: The association between the gut microbiota and metabolic disturbances in patients with nephrolithiasis is of interest for the development of individualized approaches to preventing disease recurrence. Objective: To assess the association between Akkermansia (A.) muciniphila and the clinical and metabolic characteristics of patients, as well as changes in these parameters following supplementation with this microorganism. Materials and methods: A total of 100 patients who had undergone surgical treatment were enrolled, with complete stone clearance confirmed by computed tomography. Based on qualitative polymerase chain reaction (PCR) testing of stool samples, patients were divided into 2 groups: those with detectable A. muciniphila DNA (n = 30) and those without detectable DNA of this microorganism (n = 70). Clinical characteristics, blood and 24-hour urine biochemical parameters, and stone composition were compared between the groups. Among 52 patients with recurrent nephrolithiasis in whom A. muciniphila DNA was not detected at baseline, metabolic parameters and repeat PCR results were assessed following a 2-month course of supplementation at 1, 12, and 24 months. Follow-up computed tomography was performed at 24 months to assess for recurrent stone formation. Results: At baseline, recurrent urolithiasis was observed in 3 of 30 patients with detectable A. muciniphila DNA (10.0%) and in 52 of 70 patients with a negative PCR result (74.3%). Patients with detectable DNA had lower body mass index and 24-hour urinary calcium and oxalate excretion, as well as higher 24-hour urine volume and citrate excretion. Following supplementation, favorable changes in metabolic parameters were observed in the 52 PCR-negative patients with recurrent nephrolithiasis. By month 24, the median 24-hour urine volume increased from 1.74 to 2.25 L, citrate excretion increased from 1.70 to 2.32 mmol/day, and oxalate excretion decreased from 0.449 to 0.370 mmol/day. At the 24-month follow-up, A. muciniphila DNA was detected in 45 patients (86.5%), while new stones were identified by computed tomography in 3 patients (5.8%). No adverse events were recorded during the supplementation period. Conclusion: Supplementation with a probiotic preparation containing A. muciniphila may hold promise not only for the treatment of metabolic syndrome but also as a preventive strategy to reduce the risk of recurrent urolithiasis. Metabolic syndrome is an important independent risk factor for the development and recurrence of urolithiasis. This association may be attributed to shared pathophysiological mechanisms that alter urinary biochemical composition and promote the formation of a lithogenic environment.
Source: Innovative medicine of Kuban
Author: V. V. Sergeev
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225759997