Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients
Background: Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), two uremic toxins (UTs), are associated with increased mortality in patients with chronic kidney disease (CKD). These toxins are produced by the microbiota from the diet and excreted by the kidney. The purpose of this study was to analyze...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/14/9/589 |
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| author | Manon Ebersolt Tacy Santana Machado Cecilia Mallmann Nathalie Mc-Kay Laetitia Dou Dammar Bouchouareb Philippe Brunet Stéphane Burtey Marion Sallée |
| author_facet | Manon Ebersolt Tacy Santana Machado Cecilia Mallmann Nathalie Mc-Kay Laetitia Dou Dammar Bouchouareb Philippe Brunet Stéphane Burtey Marion Sallée |
| author_sort | Manon Ebersolt |
| collection | DOAJ |
| description | Background: Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), two uremic toxins (UTs), are associated with increased mortality in patients with chronic kidney disease (CKD). These toxins are produced by the microbiota from the diet and excreted by the kidney. The purpose of this study was to analyze the effect of diet on IS and PCS concentration in hemodialysis (HD) patients. Methods: We performed a prospective monocentric study using a seven-day diet record and determination of serum IS and PCS levels in HD patients. We tested the association between toxin concentrations and nutritional data. Results: A total of 58/75 patients (77%) completed the diet record. Mean caloric intake was 22 ± 9.2 kcal/kg/day. The protein/fiber index was 4.9 ± 1.8. No correlation between IS or PCS concentration and protein/fiber index was highlighted. In the 18 anuric patients (31%) in whom residual renal function could not affect toxin concentrations, IS and PCS concentrations were negatively correlated with fiber intake and positively correlated with the protein/fiber index. In a multivariate analysis, IS serum concentration was positively associated with the protein/fiber index (<i>p</i> = 0.03). Conclusions: A low protein/fiber index is associated with low concentrations of uremic toxins in anuric HD patients. Diets with an increased fiber intake must be tested to determine whether they reduce PCS and IS serum concentrations. |
| first_indexed | 2024-03-09T22:19:51Z |
| format | Article |
| id | doaj.art-13ec82a745d5440cad816249c41f2a8f |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-09T22:19:51Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-13ec82a745d5440cad816249c41f2a8f2023-11-23T19:16:17ZengMDPI AGToxins2072-66512022-08-0114958910.3390/toxins14090589Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis PatientsManon Ebersolt0Tacy Santana Machado1Cecilia Mallmann2Nathalie Mc-Kay3Laetitia Dou4Dammar Bouchouareb5Philippe Brunet6Stéphane Burtey7Marion Sallée8Centre de Néphrologie et Transplantation Rénale, AP-HM, Hôpital de la Conception, 147 Bd Baille, 13005 Marseille, FranceAix Marseille Univ, INSERM, INRAE, C2VN, 13005 Marseille, FranceCentre D’investigation Clinique, Hôpital de la Conception, 13005 Marseille, FranceAix Marseille Univ, INSERM, INRAE, C2VN, 13005 Marseille, FranceAix Marseille Univ, INSERM, INRAE, C2VN, 13005 Marseille, FranceCentre de Néphrologie et Transplantation Rénale, AP-HM, Hôpital de la Conception, 147 Bd Baille, 13005 Marseille, FranceCentre de Néphrologie et Transplantation Rénale, AP-HM, Hôpital de la Conception, 147 Bd Baille, 13005 Marseille, FranceCentre de Néphrologie et Transplantation Rénale, AP-HM, Hôpital de la Conception, 147 Bd Baille, 13005 Marseille, FranceCentre de Néphrologie et Transplantation Rénale, AP-HM, Hôpital de la Conception, 147 Bd Baille, 13005 Marseille, FranceBackground: Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), two uremic toxins (UTs), are associated with increased mortality in patients with chronic kidney disease (CKD). These toxins are produced by the microbiota from the diet and excreted by the kidney. The purpose of this study was to analyze the effect of diet on IS and PCS concentration in hemodialysis (HD) patients. Methods: We performed a prospective monocentric study using a seven-day diet record and determination of serum IS and PCS levels in HD patients. We tested the association between toxin concentrations and nutritional data. Results: A total of 58/75 patients (77%) completed the diet record. Mean caloric intake was 22 ± 9.2 kcal/kg/day. The protein/fiber index was 4.9 ± 1.8. No correlation between IS or PCS concentration and protein/fiber index was highlighted. In the 18 anuric patients (31%) in whom residual renal function could not affect toxin concentrations, IS and PCS concentrations were negatively correlated with fiber intake and positively correlated with the protein/fiber index. In a multivariate analysis, IS serum concentration was positively associated with the protein/fiber index (<i>p</i> = 0.03). Conclusions: A low protein/fiber index is associated with low concentrations of uremic toxins in anuric HD patients. Diets with an increased fiber intake must be tested to determine whether they reduce PCS and IS serum concentrations.https://www.mdpi.com/2072-6651/14/9/589chronic kidney diseaseprotein fiber indexuremic toxinshemodialysis |
| spellingShingle | Manon Ebersolt Tacy Santana Machado Cecilia Mallmann Nathalie Mc-Kay Laetitia Dou Dammar Bouchouareb Philippe Brunet Stéphane Burtey Marion Sallée Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients Toxins chronic kidney disease protein fiber index uremic toxins hemodialysis |
| title | Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients |
| title_full | Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients |
| title_fullStr | Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients |
| title_full_unstemmed | Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients |
| title_short | Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients |
| title_sort | protein fiber index modulates uremic toxin concentrations in hemodialysis patients |
| topic | chronic kidney disease protein fiber index uremic toxins hemodialysis |
| url | https://www.mdpi.com/2072-6651/14/9/589 |
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