Abstract: TH-PO1138
Effect of Fructooligosaccharide on Endothelium Function in CKD Patients: A Randomized Controlled Trial
Session Information
- CKD: Clinical, Outcomes, Trials - I
October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
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.