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A possible link between polyunsaturated fatty acids and uremic toxins from the gut microbiota in hemodialysis patients: A hypothesis
Introduction: Indoxyl sulfate (IS) and p‐cresyl sulfate (p‐CS) are albumin‐bound uremic toxins that are difficult to remove by hemodialysis (HD). Human serum albumin (HSA) carries several compounds, including fatty acids that can bind to site II of HSA and represent competing ligands for uremic toxi...
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| Published in: | Hemodialysis international 2019-04, Vol.23 (2), p.189-197 |
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| creator | Kemp, Julie Ann Esgalhado, Marta Macedo, Renata Azevedo Regis, Bruna Damasceno, Nágila Raquel Teixeira da Silva Torres, Elizabeth Aparecida Ferraz Gonçalinho, Gustavo Henrique Ferreira Borges, Natália Alvarenga Nakao, Lia Sumie Fouque, Denis Mafra, Denise |
| description | Introduction: Indoxyl sulfate (IS) and p‐cresyl sulfate (p‐CS) are albumin‐bound uremic toxins that are difficult to remove by hemodialysis (HD). Human serum albumin (HSA) carries several compounds, including fatty acids that can bind to site II of HSA and represent competing ligands for uremic toxins. The aim of this study was to investigate the association between fatty acids and uremic toxin plasma levels in patients undergoing HD.
Methods: Thirty‐three HD patients (51.5% male, 54.9 ± 10.2 years old, 44.63 ± 28.4 months on HD, albumin level of 3.8 ± 0.3 g/dL) were evaluated. The erythrocyte fatty acid content (saturated fatty acid [SFA], monounsaturated fatty acid [MUFA], and polyunsaturated fatty acid [PUFA]) was measured by gas chromatography, and total IS and p‐CS plasma levels were measured by reversed‐phase high‐performance liquid chromatography.
Findings: The mean percentages of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) + DHA and gamma‐linolenic (GLA) acid in the erythrocyte membrane were 1.35% ± 0.74%, 1.85% ± 0.79%, and 0.33% ± 0.26%, respectively. The mean levels of IS and p‐CS were 19.4 ± 11.9 mg/dL and 101.5 ± 57.2 mg/dL, respectively. There was no significant association between SFA and MUFA and IS and p‐CS; however, a negative correlation was found between p‐CS and specific PUFAs, and the association between GLA and p‐CS levels was retained after adjusting for potential confounding variables (β = −0.49, P = 0.007).
Discussion: Polyunsaturated fatty acids may contribute to the decrease in p‐CS uremic toxin plasma levels in patients with chronic kidney disease undergoing HD. |
| doi_str_mv | 10.1111/hdi.12725 |
| format | article |
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Methods: Thirty‐three HD patients (51.5% male, 54.9 ± 10.2 years old, 44.63 ± 28.4 months on HD, albumin level of 3.8 ± 0.3 g/dL) were evaluated. The erythrocyte fatty acid content (saturated fatty acid [SFA], monounsaturated fatty acid [MUFA], and polyunsaturated fatty acid [PUFA]) was measured by gas chromatography, and total IS and p‐CS plasma levels were measured by reversed‐phase high‐performance liquid chromatography.
Findings: The mean percentages of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) + DHA and gamma‐linolenic (GLA) acid in the erythrocyte membrane were 1.35% ± 0.74%, 1.85% ± 0.79%, and 0.33% ± 0.26%, respectively. The mean levels of IS and p‐CS were 19.4 ± 11.9 mg/dL and 101.5 ± 57.2 mg/dL, respectively. There was no significant association between SFA and MUFA and IS and p‐CS; however, a negative correlation was found between p‐CS and specific PUFAs, and the association between GLA and p‐CS levels was retained after adjusting for potential confounding variables (β = −0.49, P = 0.007).
Discussion: Polyunsaturated fatty acids may contribute to the decrease in p‐CS uremic toxin plasma levels in patients with chronic kidney disease undergoing HD.</description><identifier>ISSN: 1492-7535</identifier><identifier>EISSN: 1542-4758</identifier><identifier>DOI: 10.1111/hdi.12725</identifier><identifier>PMID: 30779317</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Adolescent ; Adult ; Aged ; chronic kidney disease ; fatty acid ; Fatty Acids, Unsaturated - adverse effects ; Female ; Gastrointestinal Microbiome - physiology ; hemodialysis ; Human serum albumin ; Humans ; Male ; Middle Aged ; Renal Dialysis - adverse effects ; Renal Dialysis - methods ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - pathology ; Uremia - etiology ; uremic toxins ; Young Adult</subject><ispartof>Hemodialysis international, 2019-04, Vol.23 (2), p.189-197</ispartof><rights>2019 International Society for Hemodialysis</rights><rights>2019 International Society for Hemodialysis.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3595-8fe98344ffd0922584e5acaff515079734bc069a58997387969932fa1c2692843</citedby><cites>FETCH-LOGICAL-c3595-8fe98344ffd0922584e5acaff515079734bc069a58997387969932fa1c2692843</cites><orcidid>0000-0001-6739-8832</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhdi.12725$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhdi.12725$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30779317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kemp, Julie Ann</creatorcontrib><creatorcontrib>Esgalhado, Marta</creatorcontrib><creatorcontrib>Macedo, Renata Azevedo</creatorcontrib><creatorcontrib>Regis, Bruna</creatorcontrib><creatorcontrib>Damasceno, Nágila Raquel Teixeira</creatorcontrib><creatorcontrib>da Silva Torres, Elizabeth Aparecida Ferraz</creatorcontrib><creatorcontrib>Gonçalinho, Gustavo Henrique Ferreira</creatorcontrib><creatorcontrib>Borges, Natália Alvarenga</creatorcontrib><creatorcontrib>Nakao, Lia Sumie</creatorcontrib><creatorcontrib>Fouque, Denis</creatorcontrib><creatorcontrib>Mafra, Denise</creatorcontrib><title>A possible link between polyunsaturated fatty acids and uremic toxins from the gut microbiota in hemodialysis patients: A hypothesis</title><title>Hemodialysis international</title><addtitle>Hemodial Int</addtitle><description>Introduction: Indoxyl sulfate (IS) and p‐cresyl sulfate (p‐CS) are albumin‐bound uremic toxins that are difficult to remove by hemodialysis (HD). Human serum albumin (HSA) carries several compounds, including fatty acids that can bind to site II of HSA and represent competing ligands for uremic toxins. The aim of this study was to investigate the association between fatty acids and uremic toxin plasma levels in patients undergoing HD.
Methods: Thirty‐three HD patients (51.5% male, 54.9 ± 10.2 years old, 44.63 ± 28.4 months on HD, albumin level of 3.8 ± 0.3 g/dL) were evaluated. The erythrocyte fatty acid content (saturated fatty acid [SFA], monounsaturated fatty acid [MUFA], and polyunsaturated fatty acid [PUFA]) was measured by gas chromatography, and total IS and p‐CS plasma levels were measured by reversed‐phase high‐performance liquid chromatography.
Findings: The mean percentages of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) + DHA and gamma‐linolenic (GLA) acid in the erythrocyte membrane were 1.35% ± 0.74%, 1.85% ± 0.79%, and 0.33% ± 0.26%, respectively. The mean levels of IS and p‐CS were 19.4 ± 11.9 mg/dL and 101.5 ± 57.2 mg/dL, respectively. There was no significant association between SFA and MUFA and IS and p‐CS; however, a negative correlation was found between p‐CS and specific PUFAs, and the association between GLA and p‐CS levels was retained after adjusting for potential confounding variables (β = −0.49, P = 0.007).
Discussion: Polyunsaturated fatty acids may contribute to the decrease in p‐CS uremic toxin plasma levels in patients with chronic kidney disease undergoing HD.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>chronic kidney disease</subject><subject>fatty acid</subject><subject>Fatty Acids, Unsaturated - adverse effects</subject><subject>Female</subject><subject>Gastrointestinal Microbiome - physiology</subject><subject>hemodialysis</subject><subject>Human serum albumin</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - methods</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - pathology</subject><subject>Uremia - etiology</subject><subject>uremic toxins</subject><subject>Young Adult</subject><issn>1492-7535</issn><issn>1542-4758</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kM1O3TAQha2qqNALi74AmmW7CPg3jru7glKQkNi068hJxr0uSZzGjmj2PDiml7JjNjNz9M2R5hDyidEzlut81_kzxjVX78gRU5IXUqvqfZ6l4YVWQh2SjzH-ppQzSssP5FBQrY1g-og8bmEKMfqmR-j9eA8NpgfEMav9uozRpmW2CTtwNqUVbOu7CHbsYJlx8C2k8NePEdwcBkg7hF9LgqzPofEhWfAj7HAInbf9Gn2EySaPY4pfYQu7dQr5JMvH5MDZPuLJS9-Qn1ffflxcF7d3328utrdFK5RRReXQVEJK5zpqOFeVRGVb65xiimqjhWxaWhqrKpOXSpvSGMGdZS0vDa-k2JDPe99pDn8WjKkefGyx7-2IYYk1Z5UoJVP5bEO-7NH8Sowzunqa_WDntWa0fg69zqHX_0LP7OmL7dIM2L2S_1POwPkeePA9rm871deXN3vLJwLpjNw</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Kemp, Julie Ann</creator><creator>Esgalhado, Marta</creator><creator>Macedo, Renata Azevedo</creator><creator>Regis, Bruna</creator><creator>Damasceno, Nágila Raquel Teixeira</creator><creator>da Silva Torres, Elizabeth Aparecida Ferraz</creator><creator>Gonçalinho, Gustavo Henrique Ferreira</creator><creator>Borges, Natália Alvarenga</creator><creator>Nakao, Lia Sumie</creator><creator>Fouque, Denis</creator><creator>Mafra, Denise</creator><general>John Wiley & Sons, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6739-8832</orcidid></search><sort><creationdate>201904</creationdate><title>A possible link between polyunsaturated fatty acids and uremic toxins from the gut microbiota in hemodialysis patients: A hypothesis</title><author>Kemp, Julie Ann ; Esgalhado, Marta ; Macedo, Renata Azevedo ; Regis, Bruna ; Damasceno, Nágila Raquel Teixeira ; da Silva Torres, Elizabeth Aparecida Ferraz ; Gonçalinho, Gustavo Henrique Ferreira ; Borges, Natália Alvarenga ; Nakao, Lia Sumie ; Fouque, Denis ; Mafra, Denise</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3595-8fe98344ffd0922584e5acaff515079734bc069a58997387969932fa1c2692843</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>chronic kidney disease</topic><topic>fatty acid</topic><topic>Fatty Acids, Unsaturated - adverse effects</topic><topic>Female</topic><topic>Gastrointestinal Microbiome - physiology</topic><topic>hemodialysis</topic><topic>Human serum albumin</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - methods</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Renal Insufficiency, Chronic - pathology</topic><topic>Uremia - etiology</topic><topic>uremic toxins</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>Kemp, Julie Ann</creatorcontrib><creatorcontrib>Esgalhado, Marta</creatorcontrib><creatorcontrib>Macedo, Renata Azevedo</creatorcontrib><creatorcontrib>Regis, Bruna</creatorcontrib><creatorcontrib>Damasceno, Nágila Raquel Teixeira</creatorcontrib><creatorcontrib>da Silva Torres, Elizabeth Aparecida Ferraz</creatorcontrib><creatorcontrib>Gonçalinho, Gustavo Henrique Ferreira</creatorcontrib><creatorcontrib>Borges, Natália Alvarenga</creatorcontrib><creatorcontrib>Nakao, Lia Sumie</creatorcontrib><creatorcontrib>Fouque, Denis</creatorcontrib><creatorcontrib>Mafra, Denise</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hemodialysis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kemp, Julie Ann</au><au>Esgalhado, Marta</au><au>Macedo, Renata Azevedo</au><au>Regis, Bruna</au><au>Damasceno, Nágila Raquel Teixeira</au><au>da Silva Torres, Elizabeth Aparecida Ferraz</au><au>Gonçalinho, Gustavo Henrique Ferreira</au><au>Borges, Natália Alvarenga</au><au>Nakao, Lia Sumie</au><au>Fouque, Denis</au><au>Mafra, Denise</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A possible link between polyunsaturated fatty acids and uremic toxins from the gut microbiota in hemodialysis patients: A hypothesis</atitle><jtitle>Hemodialysis international</jtitle><addtitle>Hemodial Int</addtitle><date>2019-04</date><risdate>2019</risdate><volume>23</volume><issue>2</issue><spage>189</spage><epage>197</epage><pages>189-197</pages><issn>1492-7535</issn><eissn>1542-4758</eissn><notes>The authors declare no competing financial interest.</notes><notes>The grants were provided by the following institutes: Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).</notes><notes>Conflict of Interest</notes><notes>Disclosure of grants or other funding</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Introduction: Indoxyl sulfate (IS) and p‐cresyl sulfate (p‐CS) are albumin‐bound uremic toxins that are difficult to remove by hemodialysis (HD). Human serum albumin (HSA) carries several compounds, including fatty acids that can bind to site II of HSA and represent competing ligands for uremic toxins. The aim of this study was to investigate the association between fatty acids and uremic toxin plasma levels in patients undergoing HD.
Methods: Thirty‐three HD patients (51.5% male, 54.9 ± 10.2 years old, 44.63 ± 28.4 months on HD, albumin level of 3.8 ± 0.3 g/dL) were evaluated. The erythrocyte fatty acid content (saturated fatty acid [SFA], monounsaturated fatty acid [MUFA], and polyunsaturated fatty acid [PUFA]) was measured by gas chromatography, and total IS and p‐CS plasma levels were measured by reversed‐phase high‐performance liquid chromatography.
Findings: The mean percentages of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) + DHA and gamma‐linolenic (GLA) acid in the erythrocyte membrane were 1.35% ± 0.74%, 1.85% ± 0.79%, and 0.33% ± 0.26%, respectively. The mean levels of IS and p‐CS were 19.4 ± 11.9 mg/dL and 101.5 ± 57.2 mg/dL, respectively. There was no significant association between SFA and MUFA and IS and p‐CS; however, a negative correlation was found between p‐CS and specific PUFAs, and the association between GLA and p‐CS levels was retained after adjusting for potential confounding variables (β = −0.49, P = 0.007).
Discussion: Polyunsaturated fatty acids may contribute to the decrease in p‐CS uremic toxin plasma levels in patients with chronic kidney disease undergoing HD.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>30779317</pmid><doi>10.1111/hdi.12725</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6739-8832</orcidid></addata></record> |
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| subjects | Adolescent Adult Aged chronic kidney disease fatty acid Fatty Acids, Unsaturated - adverse effects Female Gastrointestinal Microbiome - physiology hemodialysis Human serum albumin Humans Male Middle Aged Renal Dialysis - adverse effects Renal Dialysis - methods Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - pathology Uremia - etiology uremic toxins Young Adult |
| title | A possible link between polyunsaturated fatty acids and uremic toxins from the gut microbiota in hemodialysis patients: A hypothesis |
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