Kidney Week

Abstract: FR-PO545

Effect of Resistant Starch Supplementation on the Indole-3-Acetic Acid Levels and Aryl Hydrocarbon Receptor Expression in Hemodialysis Patients

Session Information

• Physical Activity, Body Composition, Metabolism: Clinical
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Mafra, Denise, Federal University Fluminense, Rio de Janeiro, RIO DE JANEIRO, Brazil

Denise Mafra,

• Macedo, Renata De azevedo, Federal Fluminense University, Niterói, Rio de JaNEIRO, Brazil

Renata De azevedo Macedo,

• Cardozo, Ludmila Fmf, Federal Fluminense University, Niterói, Rio de JaNEIRO, Brazil

Ludmila Fmf Cardozo,

• Borges, Natalia Alvarenga, Federal University Fluminense, Rio de Janeiro, RIO DE JANEIRO, Brazil

Natalia Alvarenga Borges,

• Nakao, Lia S., UFPR, Curitiba, Brazil

Lia S. Nakao,

• Jardim, Mariana Zogbi, Federal University Fluminense, Rio de Janeiro, RIO DE JANEIRO, Brazil

Mariana Zogbi Jardim,

• Paiva, Bruna, Federal University Fluminense, Rio de Janeiro, RIO DE JANEIRO, Brazil

Bruna Paiva,

• Kemp, Julie ann, Federal University Fluminense, Rio de Janeiro, RIO DE JANEIRO, Brazil

Julie ann Kemp,

• Esgalhado, Marta, Federal University Fluminense, Rio de Janeiro, RIO DE JANEIRO, Brazil

Marta Esgalhado,

Background

Researchers have investigated the role of the gut microbiota in the pathogenesis of chronic kidney disease (CKD) and cardiovascular disease (CVD). The gut microbiota imbalance favors bacterial growth producing uremic toxins, such as indole-3-acetic acid (IAA).This toxin leads to inflammation and, the aryl hydrocarbon receptor (AhR) has been pointed as an important ligand of IAA, triggering inflammatory signaling responses. Thus, the use of prebiotics, such as resistant starch (RS), may be an effective non-pharmacological strategy to restore gut microbiota balance, reducing IAA levels and AhR expression, and consequently decreasing inflammation in CKD. The aim of this study was evaluate the effect of RS supplementation on IAA levels and AhR expression in hemodialysis patients (HD).

Methods

Randomized, double-blind, placebo-controlled clinical trial including 43 HD patients (53.4% male, 58.2 ± 9.5 years, 25.7 ± 3.8 kg/m², 37.5 ± 26.9 months of HD). The patients were supplemented with 16g/day of RS (HI-MAIZE 260) or placebo in the form of cookies (for consumption on the day of dialysis) and sachet (for daily consumption without dialysis) for 4 weeks. Blood samples were collected before and after the supplementation period. IAA plasma levels were measured by high performance liquid chromatography and, peripheral blood mononuclear cells were isolated and analyses of quantitative real time polymerase chain reaction was performed to evaluate the AhR mRNA expression.

Results

Thirty one patients completed the study, 15 in the RS group and 16 in the placebo group. No differences were found in IAA levels (2329.5 (1112-3451)mg/L vs 1667 (1191 - 2934)mg/L; p=0.16) or in AhR mRNA expression (1.08 ± 0.5 vs 1.12 ± 0.45, p=0.81) after RS supplementation. However, there was a positive correlation (r=0.48; p=0.03) between IAA and AhR at the baseline.

Conclusion

Although RS supplementation did not influence IAA levels or AhR expression, the positive association between this toxin and the AhR confirm a possible interaction between them. Future therapeutic strategies can be discovered in the sense of modulating this complex pathway.

Funding

• Government Support - Non-U.S.