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Scanning electron microscopy shows direct interaction of kidney-resident E. coli (left; yellow arrows) on typical crystal structures of calcium oxalate (CaOx) dihydrate crystals the bacteria made, which resemble kidney stones. On right, rod shaped Lactobacillus crispatus do not interact with crystals, and the few crystals generated do not resemble kidney stones.

Editor’s note: This article was originally published by Cleveland Clinic Lerner Research.

Kaltura After Publish

Cleveland Clinic researchers have found definitive proof of a kidney microbiome that influences renal health and kidney stone formation, demonstrating that the urinary tract is not sterile and low levels of bacteria are normal.

The Nature Communications publication describes the rigorous multi-pronged approach a team led by Aaron Miller, PhD, and José Agudelo, MD, used to identify and characterize the small bacterial community by combining preclinical, human and dish studies. They also identified certain bacteria within the microbiome that could promote or block kidney stone development and showed that antibiotic misuse (commonly associated with kidney stone development in a hospital setting) skewed the microbiome towards stone-promoting bacteria.

Dr. Miller hopes his team’s findings will help overturn the concept of a sterile urinary tract once and for all and lead to better prevention or treatment options for a condition that hasn’t seen major medical advances in over three decades.

“Urologic diseases like kidney stones impact 63% of the adult population and are getting worse,” he says.“The data consistently points towards bacteria. If we can’t get over the assumption of sterility, we can’t develop more effective treatments and preventative options.”