The Association Between Changes in Plasma Short-Chain Fatty Acid Concentrations and Hypertension in Children With Chronic Kidney Disease

Abstract

Background: Some children with chronic kidney disease (CKD) develop hypertension faster than others. This may be attributable to endothelial dysfunction, among other reasons. Short-chain fatty acids (SCFAs), that is, acetate, butyrate, and propionate, are known for reducing cardiovascular risks via preserving endothelial function. This study aimed to investigate the association between changes in plasma SCFA concentrations and in cardiovascular and endothelial parameters in children with CKD.Methods: In total, 105 children and adolescents who met the CKD criteria were enrolled in this study, and 65 patients aged >6 years were divided into two groups based on the ambulatory BP measurements. The parameters of plasma SCFAs, endothelial function and morphology, and echocardiography were examined at the index visit and followed up after 1 year.Results: We observed that 27.69% of 65 patients developed hypertension during the study period. Plasma acetate increased by 22.75 μM in the stable group (P < 0.001), whereas there was no change in the worsened BP group. The index higher plasma butyrate was positively correlated with worsened BP (adjusted odd ratio, 1.381; P = 0.013). At the follow-up, plasma butyrate decreased by 2.12 and 4.41 μM in the stable and worsened BP groups, respectively (P < 0.001). In 105 subjects, higher index plasma propionate was positively correlated with decreasing ejection fraction (adjusted odd ratio, 1.281; P = 0.046).Conclusions: Plasma acetate seemed to play a role in preventing hypertension in children with CKD. However, the index plasma propionate and butyrate concentrations seemed to imply the development of cardiovascular problems in our 1-year study.

Strongyloides stercoralis infection reduces Fusicatenibacter and Anaerostipes in the gut and increases bacterial amino-acid metabolism in early-stage chronic kidney disease

“…Several of these genera ( Feacalibacterium, Fusicatenibacter and Anaerostipes ), known to produce short-chain fatty acids, were present in lower abundance in the CKD_Ss+ group. Previously, it was shown that serum SCFAs were reduced in patients infected with S. stercoralis [ 21 ] and in CKD patients [ 38 ]. SCFAs are known for their effects not only on the healthy gut microbiome but also on renal function [ 39 , 40 ].…”

Probiotics ameliorate IgA nephropathy by improving gut dysbiosis and blunting NLRP3 signaling

“…Currently, research on SCFAs in diabetic nephropathy and CKD is underway, but few studies have reported the efficacy of SCFAs in IgAN. A number of studies have found that serum SCFA levels in patients with CKD are significantly lower than those in healthy volunteers and that the administration of SCFAs could reduce the level of urinary toxins in patients and could delay the progression of the disease [17,[40][41][42][43]. SCFAs could also reduce the gene and/or protein expression of inflammatory cytokines, chemokines and profibrotic factors in the kidney tissue of diabetic mice and could protect diabetic mice from kidney disease [16].…”

Faecal Microbiota Transplantation and Chronic Kidney Disease

“…An investigation that enrolled 105 children and adolescents with CKD found a difference in plasma acetate between children with and without hypertension, suggesting its preventive role for hypertension in children with CKD. In addition, reduced plasma butyrate was found in the advanced and stable blood pressure groups at the 1-year follow up, which may potentially be caused by the decline in eGFR [80]. In addition, Chai et al identified substantially lower production of SCFAs, including acetic acid, propionic acid, butyric acid, and iso-butyric acid, in IgAN patients compared with those in the control group [53].…”