Bowel Habits and the Association With Uremic Toxins in Non-Dialysis-Dependent Chronic Kidney Disease Patients

Author(s)

Ramos, Christiane Ishikawa ^{[1, 2]} ; Armani, Rachel Gatti ^{[2, 3]} ; Canziani, Maria Eugenia ^{[2, 3]} ; Dolenga, Carla Juliana Ribeiro ^[4] ; Nakao, Lia Sumie ^[4] ; Campbell, Katrina Louise ^[5] ; Cuppari, Lilian ^{[1, 2, 3]}

Affiliation

^[1] Univ Fed Sao Paulo, Nutr Program, UNIFESP, Sao Paulo, SP - Brazil

^[2] Fundacao Oswaldo Ramos, Hosp Rim, Rua Pedro de Toledo 282, BR-04039000 Sao Paulo, SP - Brazil

^[3] Univ Fed Sao Paulo, Div Nephrol, UNIFESP, Sao Paulo, SP - Brazil

^[4] Univ Fed Parana, Dept Basic Pathol, UFPR, Curitiba, Parana - Brazil

^[5] Bond Univ, Fac Hlth Sci & Med, Gold Coast - Australia

• Document type: Journal article
• Source: JOURNAL OF RENAL NUTRITION; v. 30, n. 1, p. 31-35, JAN 2020.
• Web of Science Citations: 2

Abstract

Objective: The aim of this study is to evaluate the association between bowel habits and microbial-derived uremic toxins p-cresyl sulfate (PCS) and indoxyl sulfate (IS) in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD). Design and Methods: This is a cross-sectional analysis including 43 nondiabetic NDD-CKD patients (58% men; 59.0 +/- 13.5 years; estimated glomerular filtration rate, 21.3 +/- 7.9 mL/min/1.73 m(2)). Bowel habit was assessed by the Bristol Stool Scale (BSS <3, characterized by hard consistency of stools and/or low frequency of evacuation and BSS >= 3, representing a more regular bowel habit) and by the Rome III criteria. PCS and IS (serum, free and total; urinary, total) were determined by high-performance liquid chromatography. Dietary intake was assessed by the 3-day food records. Results: The frequency of constipation assessed by BSS and Rome III criteria was 33% (n = 14/43) and 35% (n = 15/43), respectively. The BSS <3 exhibited higher PCS, independent of renal function and dietary protein-fiber ratio (beta {[}95% confidence interval [CI]]: serum, total PCS = 1.54 {[}1.06-2.23], P = .02; serum free PCS = 1.40 {[}1.00-1.97], P = .05; urinary PCS = 1.78 {[}1.10-2.90], P < .02). According to the Rome III criteria, a tendency for a higher serum total PCS (beta {[}95% CI]: 1.39 {[}0.95-2.03 mu mol/L], P = .09) and a significantly higher urinary PCS (beta {[}95% CI]: 1.80 {[}1.11-2.94 mu mol/24 h], P = .02) was found in constipated participants. No effect of a compromised bowel habit (Rome III criteria or BSS) was found on IS. Conclusion: Constipation may lead to production of PCS in nondiabetic NDD-CKD patients. (C) 2019 by the National Kidney Foundation, Inc. All rights reserved. (AU)

• FAPESP's process: 16/19724-7 - Effect of a prebiotic (fructooligosacharide) on uremic toxins of chronic kidney disease patients
• Grantee: Christiane Ishikawa Ramos
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 14/20725-2 - Effects of prebiotic (fructooligossacharide) on uremic toxins in patients with chronic kidney disease
• Grantee: Christiane Ishikawa Ramos
• Support Opportunities: Scholarships in Brazil - Doctorate