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Abstract: SA-PO178

Could a Low Protein Diet Exert Influence on Uremic Toxin Levels in Non-Dialysis CKD Patients?

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Mafra, Denise, Federal Fluminense University, Niteroi / Rj, Brazil
  • Dreux, Ana paula Black, Federal Fluminense University, Niteroi / Rj, Brazil
  • Anjos, Juliana Saraiva, Federal Fluminense University, Niteroi / Rj, Brazil
  • Stockler-Pinto, Milena Barcza, Federal Fluminense University, Niteroi / Rj, Brazil
  • Cardozo, Ludmila Fmf, Federal Fluminense University, Niteroi / Rj, Brazil
  • Dolenga, Carla J, Federal University of Parana, Curitiba, Brazil
  • Nakao, Lia S., Federal University of Parana, Curitiba, Brazil
  • Ferreira, Dennis Carvalho, UNESA-UVA, Rio de Janeiro, Brazil
  • Carmo, Flavia Lima, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
  • Rosado, Alexandre S, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
  • Carraro-Eduardo, José Carlos, Federal Fluminense University, Niteroi / Rj, Brazil
  • Borges, Natalia Alvarenga, Federal Fluminense University, Niteroi / Rj, Brazil
Background

Among many benefits for non-dialysis CKD patients, low protein diet (LPD) can be effective to modulate the gut dysbiosis reducing the influx into plasma of uremic toxins such as indoxyl-sulfate (IS), p-Cresyl Sulfate (p-CS) and Indole-3-Acetic Acid (IAA). The aim of this study was to evaluate the effects of LPD on uremic toxins serum levels and gut microbiota profile in non-dialysis CKD patients.

Methods

In this longitudinal study, LPD was prescribed for 30 non-dialysis CKD patients and anthropometric and biochemical parameters were evaluated at baseline and after 6 mo. Adherence to the diet was evaluated based on nPNA.Total concentrations serum of uremic toxins (IS, p-CS, IAA) were obtained by RP-HPLC. Fecal samples were collected to evaluate the gut microbiota profile by Polymerase Chain Reaction (PCR) and Denaturing Gradient Gel Electrophoresis analysis (DGGE). Patients were divided into 2 groups: patients who adhered to the LPD (N=14, 52.0 ±12.2yrs, eGFR, 35.2 ± 10.8 mL/min, BMI, 28.0 ± 5.0 Kg/m2) and patients who not adhered to the diet (N=16, 59.6 ±16.1 yrs, eGFR, 36.0 ± 13.7 mL/min, BMI, 30.1 ± 6.6 Kg/m2).

Results

Patients who adhered to the diet, presented a significant improvement in renal function and reduction in total and LDL cholesterol. After 6 months, the p-CS serum levels were reduced from 19.3 (9.6-24.7) to 15.5 (9.8-24.1) mg/L (p=0.03) in patients who adhered and, in contrast, levels were increased significantly in patients who not adhered to the LPD. There was no change in the average number of bands according DGGE. However, the average number of bands was positively associated with protein intake (r=0.44, p= 0.04).

Conclusion

Additionally to the improvement of renal function, LPD may be a good strategy to reduce the uremic toxins production by the gut microbiota in non-dialysis CKD patients.

Funding

  • Government Support - Non-U.S.