Kidney Week

Abstract: SA-PO178

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

Session Information

• Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nutrition, Inflammation, and Metabolism

• 1401 Nutrition, Inflammation, Metabolism

Authors

• Mafra, Denise, Federal Fluminense University, Niteroi / Rj, Brazil

Denise Mafra,

• Dreux, Ana paula Black, Federal Fluminense University, Niteroi / Rj, Brazil

Ana paula Black Dreux,

• Anjos, Juliana Saraiva, Federal Fluminense University, Niteroi / Rj, Brazil

Juliana Saraiva Anjos,

• Stockler-Pinto, Milena Barcza, Federal Fluminense University, Niteroi / Rj, Brazil

Milena Barcza Stockler-Pinto,

• Cardozo, Ludmila Fmf, Federal Fluminense University, Niteroi / Rj, Brazil

Ludmila Fmf Cardozo,

• Dolenga, Carla J, Federal University of Parana, Curitiba, Brazil

Carla J Dolenga,

• Nakao, Lia S., Federal University of Parana, Curitiba, Brazil

Lia S. Nakao,

• Ferreira, Dennis Carvalho, UNESA-UVA, Rio de Janeiro, Brazil

Dennis Carvalho Ferreira,

• Carmo, Flavia Lima, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Flavia Lima Carmo,

• Rosado, Alexandre S, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

Alexandre S Rosado,

• Carraro-Eduardo, José Carlos, Federal Fluminense University, Niteroi / Rj, Brazil

José Carlos Carraro-Eduardo,

• Borges, Natalia Alvarenga, Federal Fluminense University, Niteroi / Rj, Brazil

Natalia Alvarenga Borges,

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.