Effects of fermentable high fiber diet supplementation on gut derived and conventional nitrogenous product in patients on maintenance hemodialysis: a randomized controlled trial.

Introduction: Gut derived toxins such as p-cresol, p-cresyl sulfate (pCS) and indoxyl sulfate (IS), which belong to protein-bound uremic toxins that promote development of fibrosis inflammatory state associated with chronic kidney disease. One possible way to suppress the production of IS and pCS is...

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Publicado en:Nutrition & Metabolism Vol. 16; no. 1
Autores principales: Khosroshahi, Hamid Tayebi, Abedi, Behzad, Ghojazadeh, Morteza, Samadi, Azam, Jouyban, Abolghasem
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: BioMed Central 3/12/2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 3/12/2019
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      pub: BioMed Central
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        atl: Effects of fermentable high fiber diet supplementation on gut derived and conventional nitrogenous product in patients on maintenance hemodialysis: a randomized controlled trial.
      aug:
        au:
          Khosroshahi, Hamid Tayebi
          Abedi, Behzad
          Ghojazadeh, Morteza
          Samadi, Azam
          Jouyban, Abolghasem
        affil: Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
      sug:
        subj:
          Kidney Failure, Chronic Therapy
          Dietary Fiber Pharmacodynamics
          Glucans Pharmacodynamics
          Dietary Supplementation
          Hemodialysis
          Fermentation
          Gut Microbiota Drug Effects
          Human
          Randomized Controlled Trials
          Iran
          Urea Blood
          Creatinine Blood
          Uric Acid Blood
          Indoles Blood
          Phenols Blood
          Chromatography, High Pressure Liquid
      ab: Introduction: Gut derived toxins such as p-cresol, p-cresyl sulfate (pCS) and indoxyl sulfate (IS), which belong to protein-bound uremic toxins that promote development of fibrosis inflammatory state associated with chronic kidney disease. One possible way to suppress the production of IS and pCS is to increase dietary fiber intake. The aim of the present study was to assess whether increasing dietary fiber, as high amylose diet, can affect the level of conventional and protein bound nitrogenous products. Methods: Fifty patients with end stage renal disease (ESRD) on maintenance hemodialysis were randomly assigned to receive a diet containing resistant starch (HAM-RS2) or placebo over 8 weeks spanning February and September 2017 in the 29 Bahman hospital hemodialysis ward in Tabriz, Iran. Of these, 44 patients (23 from HAM-RS2 and 21 control) completed the study. Plasma levels of urea, creatinine, uric acid and other routine parameters were measured at the beginning and after 8 weeks of starting the supplementation. The levels of IS and p-cresol in the collected serum samples were also determined by HPLC at baseline and after intervention. Results: There was significant reduction of creatinine and uric acid levels in HAM-RS2 supplemented patients when compared with control group (P < 0.05). Serum levels of IS was not changed significantly in both HAM-RS2 treated and control patients, whereas p-cresol level was reduced significantly during the study period in HAM-RS2 treated patients (P = 0.039). The change of other parameters including Hb, lipids, bone markers and hs-CRP were non-significant during the study in both groups. Conclusion: Administration of fermentable high fiber diet as HAM-RS2 decreased serum levels of some nitrogenous products such as serum creatinine and p-cresol as a gut derived nitrogenous product without change in IS levels in maintenance hemodialysis patients. Due to safety, without important side effects the administration of diet enriched with fermentable fiber is suitable for patients on maintenance dialysis.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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