Fermentable Carbohydrate Supplementation Alters Nitrogen Excretion in Chronic Renal Failure

Younes, Hassan; Egret, Nadine; Hadj-Abdelkader, M; Rémésy, Christian; Demigné, Christian; Gueret, Claudine; Deteix, P; Alphonse, Jean-Claude

doi:10.1053/j.jrn.2005.10.007

Cited by 57 publications

(55 citation statements)

References 36 publications

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“…It appeared possible, using a diet rich in fermentable carbohydrates and low in protein, to drastically reduce the concentration of plasma urea, down to 0.75 mmol/L (Younes et al, 1996a). This urea lowering-effect of fermentable carbohydrates has been also observed in rat models of experimental renal failure (Younes et al, 1997(Younes et al, , 1998) and in patients with CRF (Rampton et al,1984;Bliss et al 1996;Younes et al, 2006). In nephrectomized rats, we have shown that feeding fermentable carbohydrates decreased the concentration of plasma urea from 32 mg/dL to 22 mg/dL, a 30% decrease.…”

Section: Role Of Fermentable Carbohydrate In the Dietetic Of Chronic supporting

confidence: 76%

“…This suggests that the large intestine can partially compensate for the renal failure, provided that an appropriate supply of fermentable carbohydrate and protein is allowed. More recently, in a prospective study (Younes et al, 2006), the impact of fermentable carbohydrates (40 g/day) on uremia and N excretion ways was investigated during five weeks in CRF patients in presence of a controlled protein diet (0.8 g/kg/day). Patients were their own controls and treated by crossing over method after randomization (5 weeks with fermentable carbohydrates vs 5 weeks without fermentable carbohydrates).…”

Section: Role Of Fermentable Carbohydrate In the Dietetic Of Chronic mentioning

confidence: 99%

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Role of Fermentable Carbohydrate Supplements in the Course of Uremia

Younes¹

2012

Chronic Kidney Disease and Renal Transplantation

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Section: Role Of Fermentable Carbohydrate In the Dietetic Of Chronic supporting

confidence: 76%

Section: Role Of Fermentable Carbohydrate In the Dietetic Of Chronic mentioning

confidence: 99%

Role of Fermentable Carbohydrate Supplements in the Course of Uremia

Younes¹

2012

Chronic Kidney Disease and Renal Transplantation

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“…Supporting this concept, several studies with small sample sizes have described an association between dietary fiber intervention and reductions of BUN and an increase in fecal nitrogen excretion in patients with CKD (19)(20)(21)(22)(23). Serum creatinine concentration decreased and eGFR increased after 4 weeks of 16.5 g/d added fiber in 13 patients with stages 3-5 CKD (23).…”

Section: Discussionmentioning

confidence: 99%

“…Consumption of fiber, which increases the energy substrate available to fecal bacteria and stimulates their proliferation, could reduce serum urea by providing a fecal route of excretion for accumulated nitrogenous wastes. Both animal (25,26) and human studies (19)(20)(21)(22)(23) have shown that fiber supplementation increases nitrogen excretion in feces and decreases serum nitrogen. Another hypothesis is that foods with fiber are also rich in antioxidants and vitamins (27), which could also relate to or influence the associations reported here.…”

Section: Discussionmentioning

confidence: 99%

Dietary Fiber, Kidney Function, Inflammation, and Mortality Risk

Huang

Risérus

et al. 2014

Clinical Journal of the American Society of Nephrology

120

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Background and objectives In the United States population, high dietary fiber intake has been associated with a lower risk of inflammation and mortality in individuals with kidney dysfunction. This study aimed to expand such findings to a Northern European population.Design, setting, participants, & measurements Dietary fiber intake was calculated from 7-day dietary records in 1110 participants aged 70-71 years from the Uppsala Longitudinal Study of Adult Men (examinations performed during 1991-1995). Dietary fiber was adjusted for total energy intake by the residual method. Renal function was estimated from the concentration of serum cystatin C, and deaths were registered prospectively during a median follow-up of 10.0 years.Results Dietary fiber independently and directly associated with eGFR (adjusted difference, 2.6 ml/min per 1.73 m 2 per 10 g/d higher; 95% confidence interval [95% CI], 0.3 to 4.9). The odds of C-reactive protein .3 mg/L were lower (linear trend, P=0.002) with higher fiber quartiles. During follow-up, 300 participants died (incidence rate of 2.87 per 100 person-years at risk). Multiplicative interactions were observed between dietary fiber intake and kidney dysfunction in the prediction of mortality. Higher dietary fiber was associated with lower mortality in unadjusted analysis. These associations were stronger in participants with kidney dysfunction (eGFR,60 ml/min per 1.73 m 2 ) (hazard ratio [HR], 0.58; 95% CI, 0.35 to 0.98) than in those without (HR, 1.30; 95% CI, 0.76 to 2.22; P value for interaction, P=0.04), and were mainly explained by a lower incidence of cancer-related deaths (0.25; 95% CI, 0.10 to 0.65) in individuals with kidney dysfunction versus individuals with an eGFR$60 ml/min per 1.73 m 2 (1.61; 95% CI, 0.69 to 3.74; P value for interaction, P=0.01).Conclusions High dietary fiber was associated with better kidney function and lower inflammation in community-dwelling elderly men from Sweden. High dietary fiber was also associated with lower (cancer) mortality risk, especially in individuals with kidney dysfunction.

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“…In one study, supplemental nutrition with probiotic activity that improved gastrointestinal flora, and diets rich in prebiotics (such as lactulose, inulin, and oligofroctose) have been used for delaying the need for dialysis in some areas. Various therapies have been developed to regulate the complex bacterial fermentation processes (17) Younes and coworkers demonstrated that fermentable carbohydrates alter colonic bacterial fermentation in CKD (18)(19). In other studies, they demonstrated that the prebiotic oligofructose-enriched inulin reduced urinary p-cresol excretion (including its sulfate conjugate) in healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

Dialysis Free Protocol for Some End Stage Renal Disease Patients (Khosroshahi Protocol)

Khosroshahi

Kalantar‐Zadeh

2012

FFHD

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ABSTRACT:Background: The number of patients with End Stage Renal Disease (ESRD) is growing annually around the world. Provision of renal replacement therapy in the form of dialysis and transplant is relatively expensive. Recent studies have shown no survival benefit of early initiation of dialysis. Given recent outcome data of the timing of dialysis treatment and the expenses and logistics of hemodialysis procedure have stimulated research on alternative strategies. The aim of this study is to introduce another type of renal replacement therapy for selective patients with advanced chronic kidney disease (CKD). Methods:In a case series we used a so-called "dialysis free protocol" consisting of a low protein diet, uremic toxin adsorbents, and prebiotics for selective ESRD patients who had dialysis access constraints or did not agree placement of hemodialysis vascular access or peritoneal dialysis catheter.Findings: clinical and biochemical results of this study showed that these patients were not deteriorating during the study period and Blood Urea Nitrogen (Bun) & serum creatinin levels were not elevated in these months. Participating patients were relatively well throughout the study without signs of florid uremia and without a need for emergent or urgent dialysis. Conclusion:We conclude that our proposed dialysis free protocol reduces the need for dialysis treatment at least transiently. Whether this protocol can reduce the need for dialysis treatment requires additional studies.

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Fermentable Carbohydrate Supplementation Alters Nitrogen Excretion in Chronic Renal Failure

Cited by 57 publications

References 36 publications

Role of Fermentable Carbohydrate Supplements in the Course of Uremia

Role of Fermentable Carbohydrate Supplements in the Course of Uremia

Dietary Fiber, Kidney Function, Inflammation, and Mortality Risk

Dialysis Free Protocol for Some End Stage Renal Disease Patients (Khosroshahi Protocol)

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