Mice lacking the oxalate transporter SLC26A6 develop hyperoxalemia, hyperoxaluria, and calciumoxalate stones as a result of a defect in intestinal oxalate secretion, but what accounts for the absorptive oxalate flux remains unknown. We measured transepithelial absorption of [14 C]oxalate simultaneously with the flux of [ 3 H]mannitol, a marker of the paracellular pathway, across intestine from wild-type and Slc26a6-null mice. We used the anion transport inhibitor DIDS to investigate other members of the SLC26 family that may mediate transcellular oxalate absorption. Absorptive flux of oxalate in duodenum was similar to mannitol, insensitive to DIDS, and nonsaturable, indicating that it is predominantly passive and paracellular. In contrast, in wild-type mice, secretory flux of oxalate in duodenum exceeded that of mannitol, was sensitive to DIDS, and saturable, indicating transcellular secretion of oxalate. In Slc26a6-null mice, secretory flux of oxalate was similar to mannitol, and no net flux of oxalate occurred. Absorptive fluxes of both oxalate and mannitol varied in parallel in different segments of small and large intestine. In epithelial cell lines, modulation of the charge selectivity of the claudin-based pore pathway did not affect oxalate permeability, but knockdown of the tight-junction protein ZO-1 enhanced permeability to oxalate and mannitol in parallel. Moreover, formation of soluble complexes with cations did not affect oxalate absorption. In conclusion, absorptive oxalate flux occurs through the paracellular "leak" pathway, and net absorption of dietary oxalate depends on the relative balance between absorption and SLC26A6-dependent transcellular secretion. 22: 224722: -225522: , 201122: . doi: 10.1681 Nephrolithiasis is the second most common chronic kidney condition after hypertension and demonstrates a rising prevalence and association with chronic kidney disease. 1 Calcium oxalate (CaOx) is the predominant component of most stones, and the level of urinary oxalate is an important risk factor for CaOx nephrolithiasis. 2,3 The amount of urinary oxalate depends on the net effect of metabolic production, intestinal absorption, and renal excretion. 4 The integral role of the intestine in oxalate homeostasis becomes most evident in diseases of intestine. Inflammatory bowel disease and small-bowel resections are conditions that are strongly associated with hyperoxaluria and CaOx nephrolithiasis. 5 New insight into the importance of the intestine in the pathogenesis of CaOx nephrolithiasis has come from studies of anion transporter SLC26A6. Slc26a6-null mice have a defect in in-
J Am Soc Nephrol