Abstract: SA-PO954
Probiotics Decreased Concentrations of Indoxylsulphate in PD Patients
Session Information
- Peritoneal Dialysis: Inflammation, Peritoneal Transport
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Chen, Xujiao, Changzheng Hospital, Shanghai, China, Shanghai, China
- Chen, Sixiu, Changzheng Hospital, Shanghai, China, Shanghai, China
- Huang, Linxi, Changzheng Hospital, Shanghai, China, Shanghai, China
- Mao, Zhiguo, Changzheng Hospital, Shanghai, China, Shanghai, China
Background
Clearance of protein-bound uremic toxins (PBUTs) by dialysis is a challenge in the treatment of uremic patients. P-cresylsulphate (PCS) and indoxylsulphate (IS) are protein-bound uremic toxins which produced in the intestine by certain intestinal bacteria, and the productions of them are affected by various intestinal environmental factors. Quantitative and qualitative alterations in gut microbiome are noted in patients with end-stage renal disease (ESRD). The indol- and p-cresol-forming bacterial families were found more abundant while the formation of short-chain fatty acidswas diminished. These changes in intestinal microbial metabolism may contribute to increased IS and PCS production. Treatment with probiotics may reduce serum/plasma PCS and IS levels, but there have been no randomised controlled trials to test the effects of probiotics on the serum PCS and IS levels in peritoneal dialysis(PD) patients.
Methods
We conducted a randomized controlled trial to evaluate the effects of probiotics on serum IS and PCS. Participants were randomized to probiotics or control group. Probiotics group received Bifid Triple Viable Capsules 0.42g orally 3 times daily for 12 weeks, IS and PCS concentrations were determined by HPLC/MS/MS and blood biochemical parameters were assessed during the study. Patients were followed up to observe the long terms clinical outcomes.
Results
A total of 60 patients were included in the clinical trial. Total IS level was significantly lower in probiotics group than in control group at week 4, 8, and 12. Free IS in probiotics group was also lower than in control group at week 8 and 12. However, there were no difference of total and free PCS between two groups during 12 weeks. After 10.20±4.48 months follow up, it showed that the incidence of peritonitis in the treatment group was significantly lower than that in the control group(log rank P=0.038). However, there were no significant difference in the incidence of PD failure, cardiovascular mortality and all-caused mortality.
Conclusion
Administration of probiotics decreased serum IS level effectively in PD patients. Benefits of PD patients' outcomes from IS reduction by probiotics awaits further large size and long duration clinical trials to verify.
Funding
- Government Support - Non-U.S.