Abstract: SA-PO820
Low Dietary Fiber Consumption Contributes to Gut Dysbiosis with Increased Fecal Indole and Circulating Indoxyl Sulfate in CKD Patients
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Authors
- Yang, David Chih-Yu, Taipei Veterans General Hospital, Taipei, Taiwan
- Tarng, Der-Cherng, Taipei Veterans General Hospital, Taipei, Taiwan
Background
Recent advances in the understanding of the role of gut microbiota and its function and composition in health and disease have revealed previously unappreciated effects of CKD-associated colonic pathology on the development of uremic complications. We aim to investigate the relationship between dietary content, gut microbiota, fecal bacterial metabolites, and circulating gut-derived uremic toxins in CKD patients.
Methods
We obtained dietary frequency questionnaires, blood, and stool samples for patients in CKD stage 5, and healthy controls. We examined and analyzed their gut microbiome by 16S rRNA sequencing and fecal indole amount. Also, we successfully developed a method for quantification of the indole level in human fecal samples.
Results
We enrolled 62 patients, among which 40 patients were CKD stage 5. Compared to healthy controls (n = 22), and we found a distinct gut microbiome between groups. Next, we stratified study subjects into age-matched subgroups, and we found that though the most dominant phylum was Bacteroides within each group, its relative abundance in the CKD group was much higher than the other two control groups. Second, three genera Fusobacterium, Shewanella, and Erwinia were present in the CKD group, but not in the others (Fig. 1). Besides, in contrast to the sum of relative abundance of the common top 10 genera in the control groups and the top 10 genera within individuals, the microbial composition of the fecal community were much diverse in a CKD patient than in the controls (Fig. 2). Furthermore, we also found that dietary fiber consumption is less, and fecal indole is higher in CKD patients (Fig. 3). Interesting, through combining FFQ and nutrient quantification, we identified that the circulating levels of total p-cresol sulfate negatively correlated with fiber-rich and ascorbic acid-rich diet intake.
Conclusion
Vegetables and fruits are enriched with dietary fibers but were instructed to be restricted in patients with advanced CKD to avoid hyperkalemia. Our data proved that such fiber-restricted diet creates an intestinal environment which is unfriendly for beneficial microbial flora with subsequent local and systemic inflammation as evidenced by increased fecal indole and increased the circulating level of indoxyl sulfate.
Funding
- Government Support - Non-U.S.