The effect of meat protein and dietary fiber on colonic function and metabolism II. Bacterial metabolites in feces and urine

Cummings, J.H.; Hill, Michael J.; Bone, E; Branch, W. J.; Jenkins, David

doi:10.1093/ajcn/32.10.2094

Cited by 316 publications

(207 citation statements)

References 21 publications

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“…The greater mass removal of both toxins in non-anuric PD patients is most probably the result of higher protein intake, which is suggested by the greater mass removal of urea nitrogen in those patients. It is well established that a high protein diet fosters bacterial protein fermentation in the large intestine, resulting in increased generation of p-cresol and indole, the precursors of PCS and IndS (25)(26)(27). Our findings are consistent with data from a large cross-sectional study showing that RRF in continuous ambulatory PD patients is correlated with dietary protein intake, independent of dialysis adequacy (28).…”

Section: Discussionsupporting

confidence: 89%

Serum Concentrations of p-Cresyl Sulfate and Indoxyl Sulfate, but Not Inflammatory Markers, Increase in Incident Peritoneal Dialysis Patients in Parallel with Loss of Residual Renal Function

Viaene¹,

Meijers²,

Vanrenterghem³

et al. 2015

Perit Dial Int

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♦ Background: High serum concentrations of the proteinbound uremic retention solutes p-cresyl sulfate (PCS) and indoxyl sulfate (IndS) and inflammation are associated with increased cardiovascular morbidity and mortality in chronic kidney disease. Renal clearance contributes to up to 80% of the total clearance of PCS and IndS in peritoneal dialysis (PD) patients. Cross-sectional studies evaluating the impact of residual renal function (RRF) on serum concentrations of PCS, IndS, and circulating inflammatory markers have yielded conflicting results. ♦ Methods: To clarify this issue, we carried out a prospective observational cohort study in incident PD patients (n = 35; 19 men; mean age: 55 ± 17 years). Midday blood samples were collected and analyzed for total serum PCS, IndS, C-reactive protein, and high-sensitivity interleukin 6. Peritoneal and renal clearances were calculated from urine and dialysate collections, and RRF was calculated as the mean of renal urea nitrogen and creatinine clearances. Patients were assessed 1, 6, 12, and 24 months after PD start. Differences between time points were analyzed using linear mixed models (LMMs). ♦ Results: Residual renal function declined significantly over time (LMM p < 0.0001). Peritoneal clearances of both toxins tended to increase, but did not compensate for the declining renal clearances. Serum concentrations of PCS and IndS increased significantly over time (LMM p = 0.01; p = 0.0009). In contrast, total mass removal of both toxins remained stable. Circulating inflammatory markers did not change over time. ♦ Conclusions: Our data indicate that serum concentrations of PCS and IndS, but not inflammatory markers, increase in incident PD patients in parallel with loss of RRF.

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Section: Discussionsupporting

confidence: 89%

Serum Concentrations of p-Cresyl Sulfate and Indoxyl Sulfate, but Not Inflammatory Markers, Increase in Incident Peritoneal Dialysis Patients in Parallel with Loss of Residual Renal Function

Viaene¹,

Meijers²,

Vanrenterghem³

et al. 2015

Perit Dial Int

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“…The production of both compounds therefore depends on the delivery of amino acids to the colon and on the activity of colonic bacteria, which may ascend to the small bowel in uremic patients (16). Studies in normal individuals have shown that the production of p-cresol can be increased by dietary protein loading and medications that impair protein digestion and decreased by maneuvers that increase the delivery of carbohydrates and fiber to the colon (13,(17)(18)(19)(20), but we could not identify differences in protein intake, medications, or bowel history that would account for the lower indican and PCS removal observed in PD patients without residual renal function. Tracer studies may ultimately be required to identify the cause of reduced indican and PCS appearance in these patients.…”

Section: Discussionmentioning

confidence: 74%

Removal of the Protein-Bound Solutes Indican and P-Cresol Sulfate by Peritoneal Dialysis

Pham

Recht

Hostetter

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Protein-bound solutes are poorly cleared by peritoneal dialysis. We examined the hypothesis that plasma concentrations of bound solutes would therefore rise as residual renal function is lost.Design, setting, participants, & measurements: Clearances of urea indican and p-cresol sulfate were measured in peritoneal dialysis patients with and without residual function.Results: In patients with residual function, protein binding restricted the peritoneal indican and p-cresol sulfate clearances to 0.3 ؎ 0.1 ml/min, as compared to the peritoneal urea clearance of 5.5 ؎ 1.1 ml/min. The urinary indican and p-cresol sulfate clearances of 2.7 ؎ 2.5 and 1.3 ؎ 1.0 ml/min were closer to the urinary urea clearance of 3.9 ؎ 2.2 ml/min, reflecting the superior ability of native kidney function to clear bound solutes. Urinary clearance thus provided the majority of the total indican and p-cresol sulfate clearances of 3.0 ؎ 2.5 and 1.6 ؎ 1.0 ml/min in patients with residual function but the minority of total urea clearance of 9.4 ؎ 2.2 ml/min. Loss of residual function lowered the total clearances for indican and p-cresol sulfate to 0.5 ؎ 0.2 and 0.4 ؎ 0.2 ml/min, whereas the urea clearance fell only slightly. However there was only a modest increase in the plasma indican level and no increase in the plasma p-cresol sulfate level in patients with no residual function because reduction in the daily removal of these solutes accompanied the reduction in their total clearance rates.Conclusions: Reduction in the removal of indican and p-cresol sulfate kept plasma levels from rising markedly when residual function was lost.

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“…Plausible explanations of why 292 increased red meat intake may contribute to IBD may 293 include increased delivery of amino acids and heme to the 294 colon where they undergo fermentation and metabolism by 295 the colonic microbiota [34], which results in the generation 296 of potentially toxic substances such as ammonia, amines, 297 N-nitroso compounds, phenols, cresols and hydrogen sul-298 fide [35,36]. Increased dietary heme from haemoglobin in 299 red meat can form reactive oxygen species, [37] Sesink 300 et al [38] showed that dietary heme increases luminal 301 cytotoxicity which causes damage to the colonic 302 epithelium.…”

Section: U N C O R R E C T E D P R O O Fmentioning

confidence: 99%

Dietary Red Meat Aggravates Dextran Sulfate Sodium-Induced Colitis in Mice Whereas Resistant Starch Attenuates Inflammation

et al. 2013

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The effect of meat protein and dietary fiber on colonic function and metabolism II. Bacterial metabolites in feces and urine

Cited by 316 publications

References 21 publications

Serum Concentrations of p-Cresyl Sulfate and Indoxyl Sulfate, but Not Inflammatory Markers, Increase in Incident Peritoneal Dialysis Patients in Parallel with Loss of Residual Renal Function

Serum Concentrations of p-Cresyl Sulfate and Indoxyl Sulfate, but Not Inflammatory Markers, Increase in Incident Peritoneal Dialysis Patients in Parallel with Loss of Residual Renal Function

Removal of the Protein-Bound Solutes Indican and P-Cresol Sulfate by Peritoneal Dialysis

Dietary Red Meat Aggravates Dextran Sulfate Sodium-Induced Colitis in Mice Whereas Resistant Starch Attenuates Inflammation

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