Department of Renal Unit of Internal Medicine, Hachioji Medical Center of Tokyo Medical University, 1163 Tate-machi, Hachioji-shi, Tokyo 193-0998, Japan.
Nephrol Dial Transplant. 2011 Mar;26(3):1094-8. doi: 10.1093/ndt/gfq624. Epub 2010 Oct 7.
para-Cresol, which is present in the blood mainly as p-cresyl sulphate, is a protein-bound uraemic toxin that is produced in the intestine by certain intestinal bacteria, and its production is affected by various intestinal environmental factors. Patients with end-stage renal disease who are undergoing haemodialysis (HD) often have defective bowel function leading to abnormal defecation. Since treatment with synbiotics (SYN), which are a combination of probiotics and prebiotics, is reported to improve bowel habit, we examined the effects of SYN on the serum p-cresol level in HD patients.
Nine HD patients received SYN (Lactobacillus casei strain Shirota and Bifidobacterium breve strain Yakult as probiotics and galacto-oligosaccharides as prebiotics) three times a day for 2 weeks. The duration of the study was 4 weeks (2 weeks of pretreatment observation and 2 weeks of treatment). The subjects were asked to complete a questionnaire about their bowel habits (defecation frequency, stool quantity, stool form and ease of defecation) during the study period. Serum p-cresol levels before and after SYN treatment were determined.
According to the questionnaire conducted during the pretreatment observation period, HD patients with a high serum p-cresol level tended to have hard stools with difficulty in defecation. With SYN treatment, stool quantity increased significantly and hard, muddy or soft stools tended to be replaced by normal ones. The serum p-cresol level also decreased significantly.
It was found that uraemic toxin, p-cresol, was associated with constipation and that SYN treatment resulted in normalization of bowel habits and a decrease of serum p-cresol levels in HD patients. Therefore, SYN treatment may be anticipated to reduce the toxic effect of p-cresol in HD patients.
对位甲酚主要以对甲酚硫酸盐的形式存在于血液中，是一种蛋白结合的尿毒素，由某些肠道细菌在肠道内产生，其产生受各种肠道环境因素的影响。接受血液透析（HD）的终末期肾病患者常存在肠道功能缺陷，导致排便异常。由于联合使用益生菌和益生元的合生元（SYN）治疗据称可以改善肠道习惯，我们研究了 SYN 对 HD 患者血清对位甲酚水平的影响。
9 名 HD 患者每天服用 SYN（干酪乳杆菌 Shirota 株和短双歧杆菌 Yakult 株作为益生菌和半乳糖寡糖作为益生元）三次，持续 2 周。研究持续时间为 4 周（2 周预处理观察和 2 周治疗）。在研究期间，要求受试者完成一份关于他们的肠道习惯（排便频率、粪便量、粪便形状和排便难易程度）的问卷。在 SYN 治疗前后测定血清对位甲酚水平。
根据预处理观察期间进行的问卷，血清对位甲酚水平较高的 HD 患者倾向于出现排便困难的硬便。用 SYN 治疗后，粪便量明显增加，硬便、泥泞或软便趋于正常。血清对位甲酚水平也显著降低。
发现尿毒症毒素对位甲酚与便秘有关，SYN 治疗可使 HD 患者的肠道习惯正常化，血清对位甲酚水平降低。因此，SYN 治疗可能会降低 HD 患者对位甲酚的毒性作用。
