The Interplay Between Oxalate, Immunity and Infection

Not Applicable

Not yet recruiting

• Conditions: Kidney Stone
• Interventions: Dietary Supplement: Low Oxalate Diet; Dietary Supplement: High Oxalate Diet

• Registration Number: NCT04605055
• Lead Sponsor: University of Alabama at Birmingham

Brief Summary

This study consists of having subjects, those with calcium oxalate kidney stones as well as healthy controls, consume low and oxalate enriched diets to investigate the role of oxalate on crystalluria (the presence of crystals in urine), immunity and infection.

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design

Study Timeline

• Study First Submitted: 2020-10-12
• Study First Submitted QC: 2020-10-21
• Study First Posted: 2020-10-27
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-16
• Last Update Posted: 2024-12-19
• Study Start: 2025-06-01
• Primary Completion: 2027-10-30
• Study Completion: 2027-12-30

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 88

Inclusion Criteria

• Able to provide informed consent
• Body Mass Index (BMI) between 20-30 kg/m2
• Non tobacco users or not pregnant/breast feeding/nursing
• Normal fasting blood comprehensive metabolic panel, complete blood count, C-reactive protein, and urinalysis. Must accurately collect two 24-hour urine collections within 20% of appropriate ratio of creatinine (mg)/body weight (kg) for gender
• Healthy subjects: No history of calcium oxalate kidney stones (CaOx KS) or other medical conditions
• Patients with CaOx KS: Recent stone composition greater than 50% CaOx; no uric acid or struvite stone content must be present. Must be first time or recurrent CaOx stone former (last stone event within the past 3 years)
• Willing to not consume supplements (i.e. vitamins, Ca (citrate or carbonate) and other minerals, herbal supplements, nutritional aids, and probiotics) for 2 weeks before the study and during the study
• Willing to abstain from vigorous exercise during the study as this may compromise immune function.
• Willing to consume diets provided only by the University of Alabama Center for Clinical and Translational Science Bionutrition Core. No food allergies or intolerance to any of the foods on the study menus.
• Willing to accurately collect 24-hour urine samples, and to have blood drawn throughout the study.
• If on medications for kidney stone prevention (e.g. thiazides, citrate supplementation excluding calcium citrate), patients must be on a stable dose regimen for at least 8 weeks prior to and during screening, with no changes in dosing anticipated during the study. Patients should not take allopurinol for 2 weeks prior to screening since allopurinol has anti-oxidant properties.

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Exclusion Criteria

• Failure to meet the inclusion criteria or physician refusal
• Inability to sign and read the informed consent
• Any medical, psychiatric, or social conditions that would prohibit participants from abiding to the study requirements
• BMI greater than 30 kg/m2 or less than 20 kg/m2
• Tobacco users or pregnant or breast feeding/nursing women
• Abnormal fasting blood comprehensive metabolic panel, complete blood count, C-reactive protein, and urinalysis. Inaccurate 24-hour urine collections.
• Healthy subjects: Taking medications or dietary supplements. History of kidney stones or any medical condition that could influence absorption or excretion of oxalate.
• Active illness including COVID-19, flu, common cold, fever, diarrhea, urinary tract infections or other infections 14 days before the study and throughout the study.
• Active disease including diabetes, gout, hypertension, primary hyperoxaluria, nephrotic syndrome, enteric hyperoxaluria, renal tubular acidosis, primary hyperparathyroidism, liver disease, autoimmune disorder, neurogenic bladder, urinary diversion, and bariatric surgery.
• Active malignancy or treatment for malignancy within 12 months prior to screening.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Low Oxalate Diet Followed by High Oxalate Diet	Low Oxalate Diet	Subjects will consume a low oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a high oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.
High Oxalate Diet Followed by Low Oxalate Diet	High Oxalate Diet	Subjects will consume a high oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a low oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.
Low Oxalate Diet Followed by High Oxalate Diet	High Oxalate Diet	Subjects will consume a low oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a high oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.
High Oxalate Diet Followed by Low Oxalate Diet	Low Oxalate Diet	Subjects will consume a high oxalate diet for four days, with blood collections on Days 1 and 4 and 24-hour urine collections on Days 3 and 4. A ten day wash out period will follow, during which participants will consume their normal diet. After the wash out period, subjects will consume a low oxalate diet for four days, with blood and 24-hour urine collections occurring again as described previously.

Primary Outcome Measures

Name	Time	Method
Monocyte Transcriptomics	Change between Baseline and Diets at 4 days	Monocyte transcriptomics will be reported as gene expression (mRNA levels)
Monocyte Mitochondrial Complex Activity	Change between Baseline and Diets at 4 days	Monocyte mitochondrial complex activity will be reported as oxygen consumption rate
Urinary Oxalate	Change between Baseline and Diets at 4 days	Twenty-four hour urinary oxalate will be reported as mg/day
Crystalluria	Change between Baseline and Diets at 4 days	Twenty-four hour crystalluria will be reported as particles/ml
Monocyte Cellular Bioenergetics	Change between Baseline and Diets at 4 days	Cellular bioenergetics will be reported as oxygen consumption rate