The role of calcium utilization of intestinal flora on urinary calcium excretion

Aim: To investigate whether calcium utilization of intestinal flora has any effect on urinary calcium excretion, like oxalate degrading effect of Oxalobacter formigenes. Materials and Methods: The data of urinary calcium excretion examinations were evaluated. 0.1 g/ml of feces samples were implanted in broths. 5 μL of 45Ca solution was added to the samples and they were incubated for 24 hours at 37 degree C. The amount of bacteriae in the samples was determined as colony forming unit (CFU). 200 μL of the samples were filtrated by 0.45 μm membrane and rinsed by 200 μL pure water. 45Ca activity (45Ca) of bacteria in the membrane was counted by GM detector for 100 seconds. Then, activity per CFU (45Ca/CFU) was calculated and compared in hypercalciuric (calciuria >4; mg/kg/hour and/or calcium/creatinine ratio>0.21; Group I) and normocalciuric (Group II) patients. Results: Samples of 29 patients with a mean age of 7.50±4.28 (1.5-16) years were evaluated. 11 of them were female (M/F: 18/11). There were 14 patients in Group I and 15 patients in Group II, 45Ca/CFU was not different for neither aerobic nor anaerobic bacteries between the two groups (p:0.983, p:0.601, respectively). 24-hour urine calcium levels were negatively but not significantly correlated to aerobic and anaerobic 45Ca/CFU (p:0.079, r:-0.145; p:0.260, r:-0.420, respectively) in hypercalciuric patients. Besides, in normocalciuric patients, 24-hour urine calcium levels were correlated positively to aerobic and negatively to anaerobic 45Ca/CFU again in an insignificant manner (p:0.509, r: 0.223; p:0623, r:-0.257, respectively). Conclusion: In this, study, similar 45Ca/CFU levels in both hypercalciuric and normocalciuric patients imply that calcium utilization of intestinal flora does not have a distinct effect on urinary calcium excretion but, although not significant, there was a negative correlation between urine calcium levels and bacterial 45Ca/CFU levels especially in hypercalciuric patients.