Patients who suffer from a particular type of kidney stones could benefit from a new drug being trialled at the Royal Free Hospital (RFH).
People with inflammatory bowel disease, including conditions like Crohn’s disease, sometimes struggle to metabolise (convert) a substance found in many foods called oxalate. This can lead to oxalate crystals – kidney stones – forming in the kidneys and urinary tract and in rare cases this can lead to kidney failure. If kidney function decreases, oxalate can then accumulate in the blood and is then deposited in other tissues around the body causing permanent damage.
A new drug, ALLN-177, contains an enzyme which breaks down oxalate in the gut, before it reaches the kidneys.
The RFH is a leading centre for treating patients who accumulate oxalate in this way – the condition is known as hyperoxaluria. Some types of hyperoxaluria are genetic, but another type known as enteric hyperoxaluria occurs in some patients with gastrointestinal diseases.
“This drug would be the first specific treatment for kidney stones”
Dr Shabbir Moochhala (pictured), national co-ordinating investigator for the study and consultant nephrologist at RFH, said: “If shown to be effective, this drug would be the first specific treatment for kidney stones in this patient population. “People that could potentially benefit are kidney stone formers who have Crohn’s disease and other inflammatory bowel diseases, plus those who have disorders of the pancreas due to cystic fibrosis or pancreatitis. The drug could also potentially help in some cases after gastric bypass or intestinal surgery, as these conditions can lead to abnormal absorption of oxalate.”
Approximately 124 participants who have enteric hyperoxaluria will be enrolled in the study which is being conducted in the United States and Europe. The Metabolic Kidney Stone Service at RFH is one of only a handful of clinics in the UK that specialise in the diagnosis and treatment of rare conditions that can cause recurrent kidney stones.