Oral microbiota and urinary system diseases: from mechanistic insights to clinical implications—a comprehensive review

The human oral microbiome has attracted considerable attention due to its role in oral health and potential implications for systemic diseases. Oral microbes provide real-time insights into health and disease status, making them valuable for early disease risk stratification and treatment outcome prediction. Accumulating evidence indicates that oral microbiota contribute to the pathogenesis of urinary system diseases. Notably, in pediatric populations, the oral microbiome-shaped by age, feeding patterns, and immune maturation-may modulate susceptibility to renal-related systemic conditions; clinical observations specifically link untreated early childhood caries to an increased risk of Henoch-Schönlein purpura nephritis (HSPN). This review critically appraises the existing literature to clarify the nature and magnitude of the association between the oral microbiome and urinary system diseases, including chronic kidney disease, urolithiasis, benign prostatic hyperplasia, and urologic cancers, as well as pediatric HSPN. We also analyze the potential mechanisms through which the oral microbiota are involved in the pathogenesis and progression of these relevant diseases, and explore its potential implications for the prevention, diagnosis, and management of urinary system disorders.