ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO1138

Effect of Fructooligosaccharide on Endothelium Function in CKD Patients: A Randomized Controlled Trial

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Armani, Rachel Gatti, Division of Nephrology - Federal University of São Paulo, Sao Paulo, Brazil
  • Ramos, Christiane Ishikawa, Division of Nephrology - Federal University of São Paulo, Sao Paulo, Brazil
  • Cuppari, Lilian, Division of Nephrology - Federal University of São Paulo, Sao Paulo, Brazil
  • Canziani, Maria Eugenia F., Division of Nephrology - Federal University of São Paulo, Sao Paulo, Brazil
Background

Microbiota-derived uremic toxins have been associated with increased cardiovascular risk in chronic kidney disease (CKD). This has encouraged the investigation of alternative paths to modulate gut environment with ensuing reduction of toxin production, inflammation and endothelial dysfunction. This trial aimed to evaluate the effect of the prebiotic fructooligosaccharide (FOS) on endothelial dysfunction in CKD non-dialysis patients.

Methods

The 3-month double-blind randomized controlled trial included 46 non-diabetic CKD patients [52% men; 57.6±14.4 years; eGFR: 21.3±7.3 mL/min/1.73m]. Intervention and placebo consisted in 12g/day of FOS or maltodextrin, respectively. P-cresyl sulfate (PCS), indoxyl sulfate (IS), Interleukin 6 (IL6) were evaluated. Endothelial dysfunction was assessed through stroma derived factor 1 alfa (SDF1α), serum nitric oxide (NO) and flow-mediated dilatation (FMD).

Results

Aside for the intervention group being older (53.4±16.0 vs 61.9±11.4,p=0.04) the groups were homogeneous. During the study, renal function, electrolytes, remained stable in both groups. A downward trend in PCS serum levels (52.86±30.68 vs 43.06±32.43mg/L,p=0.07) was observed in the treated group. Regarding inflammation, IL6 decreased in this group (3.14±2.22 vs 2.65±1.37 pg/mL, p=0.04). There was no difference in NO, SDF1α levels and FMD (Figure 1). In an exploratory analysis, including only patients with less damaged endothelium at baseline (FMD≥2.2% median), we observed that treated group had significant greater values of FMD after 3 months (p=0.04).

Conclusion

There was no effect of FOS on endothelial function in the studied population. Nonetheless, in patients with less damaged endothelium at baseline, we could observe an improvement of endothelial dilatation in the treated group, which could suggest a potential impact of FOS in the recovery of endothelial function.

Funding

  • Government Support - Non-U.S.