In this study, urinary stone disease patients will be recruited from the Park City Urology Clinic at Intermountain Healthcare.~Subjects will undergo screening and baseline assessments, including a history and physical exam. A 24-hour urine sample will be collected. Urinary parameters include analysis for calcium, oxalate, uric acid, citrate, NH4, sulfate, pH, Cr, phosphate, sodium, potassium, magnesium, super saturation (SS) CaOx, SSUA, SSCaP, UUN.~Microbial Transplant Therapy (MTT), the intervention, will be offered to individuals who produce greater than 60% calcium-oxalate stones. Pathology reports in the patient's medical record will be used to confirm the stone composition. The cohort of 36 total enrollees will be comprised of three separate study groups of 12 each. The first group of 12 will include hyperoxaluric patients, the second group of 12 will include hypercalciuric patients and the third group will enroll patients with either hyperoxaluria or hypercalciuria as our control group. Grouping will be determined by 24-hour urine analysis which show measurements of urinary calcium >225mg/day (hypercalciuric group) and oxalate >40mg/day (hyperoxaluric group).~Stool samples will be obtained for metagenomic analyses prior to the intervention.~Subjects will be assigned to the hypercalciuric and hyperoxaluric arms based upon urine parameters or placed in the control arm by random assignment. Because antibiotic treatment is common during surgery for stones, participants will be treated with 3 days of vancomycin 500 mg orally twice a day and neomycin 1,000 mg orally twice a day. Twenty-four hours later, participants will take either the control capsule or the microbial capsules, 2 capsules daily for 7 days.
The purpose of this study is to measure the impact of Microbial Transplant Therapy (MTT) on 24-hour urine parameters in recurrent hypercalciuric and hyperoxaluric kidney stone formers.