Abstract | BACKGROUND AND OBJECTIVES: DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Fifty-six patients on maintenance hemodialysis were randomly assigned to receive supplements containing resistant starch (n=28) or control starch (n=28) daily for 6 weeks in a study conducted between October 2010 and May 2013. Of these, 40 patients (20 in each group) completed the study and were included in the final analysis. Plasma indoxyl sulfate and p-cresol sulfate levels were measured at baseline and week 6. RESULTS: Increasing dietary fiber for 6 weeks significantly reduced the unbound, free plasma level of indoxyl sulfate (median -29% [25th percentile, 75th percentile, -56, -12] for fiber versus -0.4% [-20, 34] for control, P=0.02). The reduction in free plasma levels of indoxyl sulfate was accompanied by a reduction in free plasma levels of p-cresol sulfate (r=0.81, P<0.001). However, the reduction of p-cresol sulfate levels was of lesser magnitude and did not achieve significance (median -28% [-46, 5] for fiber versus 4% [-28, 36] for control, P=0.05). CONCLUSIONS: Increasing dietary fiber in hemodialysis patients may reduce the plasma levels of the colon-derived solutes indoxyl sulfate and possibly p-cresol sulfate without the need to intensify dialysis treatments. Further studies are required to determine whether such reduction provides clinical benefits.
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Authors | Tammy L Sirich, Natalie S Plummer, Christopher D Gardner, Thomas H Hostetter, Timothy W Meyer |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 9
Issue 9
Pg. 1603-10
(Sep 05 2014)
ISSN: 1555-905X [Electronic] United States |
PMID | 25147155
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2014 by the American Society of Nephrology. |
Chemical References |
- Cresols
- Dietary Fiber
- Sulfuric Acid Esters
- 4-cresol sulfate
- Indican
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Topics |
- Colon
(metabolism)
- Cresols
(blood)
- Dietary Fiber
(administration & dosage)
- Female
- Humans
- Indican
(blood)
- Male
- Middle Aged
- Prospective Studies
- Renal Dialysis
- Single-Blind Method
- Sulfuric Acid Esters
(blood)
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