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RecruitingNCT06330246Updated Aug 27, 2026

O. Formigenes Colonization in Calcium Oxalate Kidney Stone Disease

An interventional study of Low oxalate fixed diets pre-colonization and Moderately high oxalate fixed diets pre-colonization in Kidney Stone, Kidney Calculi and Urolithiasis, sponsored by University of Alabama at Birmingham. Recruiting at 2 sites in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-08-27.

Sponsored by University of Alabama at Birmingham · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years to 70 Years
Sex
All
01

Study summary

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
Read the detailed description

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.

02

Conditions studied

  • Kidney Stone
  • Kidney Calculi
  • Urolithiasis
  • Urolithiasis, Calcium Oxalate
  • Nephrolithiasis
  • Nephrolithiasis, Calcium Oxalate
  • Oxalate Urolithiasis
  • Oxaluria
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

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
04

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    colonization with Oxalobacter formigenes

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

    Dietary Supplement: Low oxalate fixed diets pre-colonization · Dietary Supplement: Moderately high oxalate fixed diets pre-colonization · Dietary Supplement: Colonization with Oxalobacter formigenes · Dietary Supplement: Low oxalate fixed diets post-colonization · Dietary Supplement: Moderately high oxalate fixed diets post-colonization

Interventions

  • Dietary supplementLow oxalate fixed diets pre-colonization

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

  • Dietary supplementModerately 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)

  • Dietary supplementColonization with Oxalobacter formigenes

    Ingestion of live Oxalobacter formigenes

  • Dietary supplementLow oxalate fixed diets post-colonization

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

  • Dietary supplementModerately 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)

05

What researchers measure

Primary outcomes

  1. Change in urinary oxalate excretion following colonization with Oxalobacter formigenes

    Difference between urinary oxalate excretion on the moderately high oxalate diet pre-colonization and urinary oxalate excretion on the moderately high oxalate diet post-colonization

    Time frame: 2 months

Secondary outcomes

  1. Sustainability of colonization with Oxalobacter formigenes

    duration of colonization after successful induction of colonization sith Oxalobacter formigenes

    Time frame: 4 years

06

Study locations

2 of 2 sites recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06330246
Lead sponsor
University of Alabama at Birmingham
Collaborators
University of Texas Southwestern Medical Center, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Responsible party
Sonia Fargue (Assistant Professor, University of Alabama at Birmingham) — Principal investigator
First posted
Mar 26, 2024
Start date
Apr 17, 2024
Primary completion
Dec 31, 2030 (estimated)
Completion
Dec 31, 2031 (estimated)
Last update
Aug 27, 2026

Study contacts

Sonia Fargue, PhD
Contact
sfargue@uab.edu
2059756932
Demond Wiley
Contact
kidneystone@uabmc.edu
2059345712
Sonia Fargue, PhD
principal investigator · University of Alabama at Birmingham

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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