Comparative Gut Microbiome Differences between Ferric Citrate and Calcium Carbonate Phosphate Binders in Patients with End-Stage Kidney Disease

Wu, Ping; Liu, Po-Yu; Chiu, Ya Wen; Hung, Wen Chun; Lin, Yi Ting; Lin, Ting Yun; Hung, Szu Chun; Delicano, Rachel Ann; Kuo, Mei Chuan; Wu, Chun Ying

doi:10.3390/microorganisms8122040

Cited by 20 publications

(10 citation statements)

References 55 publications

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“…Consistent with the alleviated DKD symptoms in Db-FM groups, improvement in the gut microbiota was also identified. In line with what we found, the reduction of bacterial diversity has been reported previously exist in patients ( 63 , 64 ) and animal models ( 65 ) with kidney disease. We, therefore, speculate that the promotion of microbial diversity index may be attributed to the prebiotic properties of FG-FM and beneficial for the alleviation of nephropathy symptoms in diabetic mice ( 66 ).…”

Section: Discussionsupporting

confidence: 93%

The Preventive Effects of Fermented and Germinated Foxtail Millet Whole Grain on Kidney Damage in a Diabetic Mouse Model

et al. 2022

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Diabetic kidney disease (DKD) is an important complication of diabetes. The prevention of DKD can effectively reduce the mortality rate of diabetic patients and improve their quality of life. The present study examined the effects of fermented and germinated foxtail millet whole grain (FG-FM) on kidney lesions in a diabetic mouse model (Db/Db mice). The results proved that the FG-FM consumption significantly alleviated the kidney tissue damage in the diabetic mouse model. The transcriptome analysis of kidney tissues demonstrated that the overactivation of signaling pathways related to inflammation and immunity in the diabetic mouse model was significantly inhibited with the FG-FM intake. Moreover, the consumption of the FG-FM diet effectively elevated the bacterial diversity, increased the relative abundance of probiotics and decreased the relative abundance of previously reported DKD-related bacteria in the gut microbiota of diabetic mice. Our study confirmed foxtail millet as a potential source of functional food for the non-pharmacological intervention of DKD.

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Section: Discussionsupporting

confidence: 93%

The Preventive Effects of Fermented and Germinated Foxtail Millet Whole Grain on Kidney Damage in a Diabetic Mouse Model

et al. 2022

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“…On top of these untoward effects of dietary intervention on vitamin K intake, different PBs have been shown, both in vitro and in vivo, to bind vitamin K, thereby limiting its bioavailability [15][16][17]. Sevelamer seems to bind vitamin K directly [16]; however, there might also be an effect on microbiota by sevelamer and calcium carbonate treatment [35,36]. Moreover, in patients on renal replacement therapy, an association of sevelamer carbonate use and increased dp-ucMGP levels was observed, suggesting that PB therapy aggravates vitamin K deficiency [18].…”

Section: Discussionmentioning

confidence: 99%

Combining phosphate binder therapy with vitamin K2 inhibits vascular calcification in an experimental animal model of kidney failure

Neradová

Wasilewski

Prisco

et al. 2021

Nephrology Dialysis Transplantation

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Background Hyperphosphatemia is strongly associated with cardiovascular disease and mortality. Recently, phosphate binders (PBs), which are used to bind intestinal phosphate have been shown also to bind vitamin K, thereby potentially aggravating vitamin K deficiency. This vitamin K-binding by PBs may offset beneficial effects of phosphate level reduction on reducing vascular calcification (VC). Here we assessed whether combining PBs with vitamin K2 supplementation inhibits VC. Methods We performed 3/4Nx in rats, after which warfarin was given for three weeks to induce vitamin K-deficiency. Next, animals were fed a high phosphate diet in the presence of low or high vitamin K2 and were randomized to either control or one of four different PBs for eight weeks. Primary outcome was the amount of thoracic and abdominal aorta VC measured by high-resolution micro-Computed Tomography (μ-CT). Vitamin K status was measured by plasma MK7 levels and immunohistochemically analyzed in vasculature using ucMGP specific antibodies. Results Combination of high vitamin K2 diet and PB treatment significantly reduced VC as measured by μ-CT, for both thoracic (p = 0.026) and abdominal aorta (p = 0.023), compared to MK7 or PB treatment alone. UcMGP stain was significantly more present in the low vitamin K2 treated groups in both thoracic (p<0.01) and abdominal aorta (p<0.01) as compared to high vitamin K2 treated groups. Moreover, high vitamin K diet and PBs led to reduced vascular oxidative stress. Conclusion In an animal model of kidney failure with vitamin K-deficiency, neither PB therapy nor vitamin K2 supplementation alone prevented VC. However, the combination of high vitamin K2 with PB treatment significantly attenuated VC.

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“…They observed that CKD rats had lower relative abundances of some Firmicutes and Lactobacillus and a lower gut microbial diversity compared to normal rats, but they also described that ferric citrate treatment in CKD rats increased bacterial diversity almost to levels observed in control rats and that this treatment did not increase uremic toxins. In a recent study, Wu et al [36], compared hemodialysis patients gut microbiome treated with either calcium carbonate or ferric citrate. They observed a significantly increased microbial diversity in the group treated with ferric citrate, with an increased abundance of Bacteroidetes and a decreased abundance of Firmicutes.…”

Section: Discussionmentioning

confidence: 99%

Gut microbiome in hemodialysis patients treated with calcium acetate or treated with sucroferric oxyhydroxide: a pilot study

et al. 2021

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Purpose It has been proved that the gut microbiome is altered in patients with chronic kidney disease. This contributes to chronic inflammation and increases cardiovascular risk and mortality, especially in those undergoing hemodialysis. Phosphate binders may potentially induce changes in their microbiome. This trial aimed to compare the changes in the gut microbiome of hemodialysis patients treated with calcium acetate to those treated with sucroferric oxyhydroxide. Methods Twelve hemodialysis patients were distributed to receive calcium acetate or sucroferric oxyhydroxide for 5 months. Blood samples (for biochemical analysis) and stool samples (for microbiome analysis) were collected at baseline, 4, 12, and 20 weeks after treatment initiation. Fecal DNA was extracted and a 16S rRNA sequencing library was constructed targeting the V3 and V4 hypervariable regions. Results Regarding clinical variables and laboratory parameters, no statistically significant differences were observed between calcium acetate or sucroferric oxyhydroxide groups. When analyzing stool samples, we found that all patients were different (p = 0.001) among themselves and these differences were kept along the 20 weeks of treatment. The clustering analysis in microbial profiles grouped the samples of the same patient independently of the treatment followed and the stage of the treatment. Conclusion These results suggest that a 5-month treatment with either calcium acetate or sucroferric oxyhydroxide did not modify baseline diversity or baseline bacterial composition in hemodialysis patients, also about the high-variability profiles of the gut microbiome found among these patients.

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Comparative Gut Microbiome Differences between Ferric Citrate and Calcium Carbonate Phosphate Binders in Patients with End-Stage Kidney Disease

Cited by 20 publications

References 55 publications

The Preventive Effects of Fermented and Germinated Foxtail Millet Whole Grain on Kidney Damage in a Diabetic Mouse Model

The Preventive Effects of Fermented and Germinated Foxtail Millet Whole Grain on Kidney Damage in a Diabetic Mouse Model

Combining phosphate binder therapy with vitamin K2 inhibits vascular calcification in an experimental animal model of kidney failure

Gut microbiome in hemodialysis patients treated with calcium acetate or treated with sucroferric oxyhydroxide: a pilot study

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