Effect of sucroferric oxyhydroxide on gastrointestinal microbiome and uremic toxins in patients with chronic kidney disease undergoing hemodialysis.
Aged
Aged, 80 and over
Case-Control Studies
Cresols
/ blood
Drug Combinations
Dysbiosis
/ drug therapy
Feces
/ microbiology
Ferric Compounds
/ pharmacology
Gastrointestinal Microbiome
/ drug effects
Humans
Indican
/ blood
Middle Aged
Renal Dialysis
Renal Insufficiency, Chronic
/ blood
Sucrose
/ pharmacology
Sulfuric Acid Esters
/ blood
Chronic kidney disease
Gastrointestinal microbiome
Indoxyl sulfate
Serum uremic toxin
Sucroferric oxyhydroxide
p-Cresyl sulfate
Journal
Clinical and experimental nephrology
ISSN: 1437-7799
Titre abrégé: Clin Exp Nephrol
Pays: Japan
ID NLM: 9709923
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
07
11
2019
accepted:
03
04
2020
pubmed:
15
4
2020
medline:
7
7
2021
entrez:
15
4
2020
Statut:
ppublish
Résumé
In patients with chronic kidney disease (CKD), dysbiosis in the gastrointestinal microbiome is thought to be associated with increased production of uremic toxins, such as indoxyl sulfate (IS) and p-cresyl sulfate (PCS). Sucroferric oxyhydroxide (SFO), an iron-based phosphate binder, may affect the gastrointestinal microbiome and the production of uremic toxins. We aimed to examine whether SFO administration affected distribution of gastrointestinal microbiome and serum uremic toxin levels in CKD patients undergoing hemodialysis. In this single-center, open-label, interventional study, 18 maintenance hemodialysis patients with hyperphosphatemia were prescribed with SFO. We collected serum samples before and after 3 months of administration, and serum levels of IS and PCS were measured. A control group of 20 hemodialysis patients without SFO was evaluated. We evaluated gastrointestinal microbiome of patients pre- and post-SFO administration by 16S rDNA sequencing and bioinformatics analysis. Serum IS and PCS levels were significantly elevated after administration of SFO (IS before 2.52 ± 1.60 mg/dl vs. after 3.13 ± 1.51 mg/dl, P = 0.008; PCS before 2.32 ± 2.44 mg/dl vs. after 3.45 ± 2.11 mg/dl, P = 0.002), while serum IS and PCS levels did not change in the control group. Microbiome analysis in the SFO group showed no significant change in diversity and major components in phylum, class, order, family, gene, and species. Administration of SFO increased the serum levels of IS and PCS with no change of major components of gastrointestinal microbiome.
Sections du résumé
BACKGROUND
BACKGROUND
In patients with chronic kidney disease (CKD), dysbiosis in the gastrointestinal microbiome is thought to be associated with increased production of uremic toxins, such as indoxyl sulfate (IS) and p-cresyl sulfate (PCS). Sucroferric oxyhydroxide (SFO), an iron-based phosphate binder, may affect the gastrointestinal microbiome and the production of uremic toxins. We aimed to examine whether SFO administration affected distribution of gastrointestinal microbiome and serum uremic toxin levels in CKD patients undergoing hemodialysis.
METHODS
METHODS
In this single-center, open-label, interventional study, 18 maintenance hemodialysis patients with hyperphosphatemia were prescribed with SFO. We collected serum samples before and after 3 months of administration, and serum levels of IS and PCS were measured. A control group of 20 hemodialysis patients without SFO was evaluated. We evaluated gastrointestinal microbiome of patients pre- and post-SFO administration by 16S rDNA sequencing and bioinformatics analysis.
RESULTS
RESULTS
Serum IS and PCS levels were significantly elevated after administration of SFO (IS before 2.52 ± 1.60 mg/dl vs. after 3.13 ± 1.51 mg/dl, P = 0.008; PCS before 2.32 ± 2.44 mg/dl vs. after 3.45 ± 2.11 mg/dl, P = 0.002), while serum IS and PCS levels did not change in the control group. Microbiome analysis in the SFO group showed no significant change in diversity and major components in phylum, class, order, family, gene, and species.
CONCLUSION
CONCLUSIONS
Administration of SFO increased the serum levels of IS and PCS with no change of major components of gastrointestinal microbiome.
Identifiants
pubmed: 32285213
doi: 10.1007/s10157-020-01892-x
pii: 10.1007/s10157-020-01892-x
doi:
Substances chimiques
Cresols
0
Drug Combinations
0
Ferric Compounds
0
Sulfuric Acid Esters
0
sucroferric oxyhydroxide
0
4-cresol sulfate
56M34ZQY1S
Sucrose
57-50-1
Indican
N187WK1Y1J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
725-733Subventions
Organisme : Kidney Foundation, Japan
ID : JKFB16-25
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