Kidney Week

Abstract: SA-PO149

Effects of Resistant Starch Supplementation on Inflammatory and Oxidative Stress Status in Hemodialysis Patients: A Pilot Randomized, Double-Blind, Placebo-Controlled Clinical Trial

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, Niterói, RIO DE JANEIRO, Brazil

Denise Mafra,

• Esgalhado, Marta, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Marta Esgalhado,

• Stockler-Pinto, Milena Barcza, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Milena Barcza Stockler-Pinto,

• Borges, Natalia Alvarenga, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Natalia Alvarenga Borges,

• Cardozo, Ludmila Fmf, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Ludmila Fmf Cardozo,

• Paiva, Bruna, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Bruna Paiva,

• Jardim, Mariana Zogbi, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Mariana Zogbi Jardim,

• Kemp, Julie ann, Federal Fluminense University, Niterói, RIO DE JANEIRO, Brazil

Julie ann Kemp,

Background

In recent years, researchers have suggested that gut microbiota imbalance may be considered as a new cardiovascular risk factor in chronic kidney disease (CKD) patients, once it is associated with inflammatory and oxidative stress state. In this context, prebiotics use has been pointed out as a promising non-pharmacological therapeutic strategy by reestablishing the gut microbiota balance. The aim of this study was to determine the effect of resistant starch (RS) (as prebiotic source) supplementation on inflammatory and oxidative stress status on hemodialysis (HD) patients.

Methods

This randomized, double-blind, placebo-controlled clinical trial evaluated 20 CKD patients on HD (55% male, 55.6 ± 10.7 years, 30.5 (14.2 – 62) months HD vintage, BMI, 26.5 ± 4.8 kg/m²). Patients were randomized to receive prebiotic (10 patients received 9 cookies/d in the dialysis days and 1 sachet/d in non-dialysis days, containing 16g of RS- Hi-Maize 260, Ingredion®) or placebo (10 patients received cookies and sachets - containing manioc flour) for 4 weeks. High sensitive C-reactive protein (hs-CRP) was analyzed using Bioclin® kit by automatic biochemical analyzer, interleukin (IL)-6 plasma levels were performed by ELISA and, malonaldehyde (MDA) plasma levels, a common marker of lipid peroxidation, were measured by thiobarbituric acid reaction. Routine biochemical parameters and nutritional status were also obtained.

Results

There was no significant difference between baseline values for any variable in both groups. After 4 weeks of RS supplementation, there was a significant reduction in IL-6 (from 3.47 ± 0.004 to 3.46 ± 0.001 pg/mL, p= 0.001) and MDA (from 4.64 ± 2.47 to 2.33 ± 1.57 nmol/mL, p=0.04) plasma levels. No change was observed in placebo group.

Conclusion

Data from this randomized study suggest that RS supplementation may modulate inflammation and oxidative stress in HD patients. These findings support the need for more studies with prebiotics in CKD patients to confirm the hypothesis that they could be a new non-pharmacological therapeutic strategy to modulate gut microbiota in these patients and reduce complications related to its imbalance.

Funding

• Government Support - Non-U.S.