Department of Renal Centre. Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University.
College of Pharmaceutical Sciences. Zhejiang University of Technology.
Nutr Hosp. 2023 Aug 28;40(4):819-828. doi: 10.20960/nh.04643.
Objective: this study aimed to evaluate whether low-salt low-protein diet (LPD) supplemented with 10 g of inulin could lower serum toxin levels in patients with chronic kidney disease (CKD), thereby providing evidence for adjusting dietary prescriptions of inhospital patients and outpatient nutrition consultants. Methods: we randomized 54 patients with CKD into two groups. Dietary protein intake compliance was evaluated using a 3-day dietary diary and 24-h urine nitrogen levels. The primary outcomes were indoxyl sulfate (IS) and p-cresyl sulfate (PCS), and secondary outcomes included inflammation marker levels, nutritional status, and renal function. We assessed 89 patients for eligibility, and a total of 45 patients completed the study, including 23 and 22 in the inulin-added and control groups, respectively. Results: PCS values decreased in both groups after intervention: inulin-added group, ∆PCS -1.33 (-4.88, -0.63) μg/mL vs. LPD group, -4.7 (-3.78, 3.69) μg/mL (p = 0.058). PCS values reduced from 7.52 to 4.02 μg/mL (p < 0.001) in the inulin-added group (p < 0.001). Moreover, IS decreased from 3.42 (2.53, 6.01) μg/mL to 2.83 (1.67, 4.74) μg/mL after adding inulin; ∆IS was -0.64 (-1.48, 0.00) μg/mL, and a significant difference was observed compared with the control group (p = 0.004). The inflammation index decreased after intervention. Conclusion: dietary fiber supplementation may reduce serum IS and PCS levels and modulate their inflammatory status in predialysis CKD patients.
本研究旨在评估低蛋白低盐饮食（LPD）联合 10g 菊粉是否能降低慢性肾脏病（CKD）患者的血清毒素水平，为调整住院患者和门诊营养顾问的饮食处方提供依据。方法：我们将 54 例 CKD 患者随机分为两组。通过 3 天饮食日记和 24 小时尿氮水平评估膳食蛋白质摄入的依从性。主要终点为吲哚硫酸（IS）和对甲酚硫酸（PCS），次要终点包括炎症标志物水平、营养状况和肾功能。我们对 89 例患者进行了入选评估，共有 45 例患者完成了研究，其中添加菊粉组 23 例，对照组 22 例。结果：两组干预后 PCS 值均降低：添加菊粉组 ∆PCS -1.33（-4.88，-0.63）μg/mL 比 LPD 组-4.7（-3.78，3.69）μg/mL（p=0.058）。添加菊粉组 PCS 值从 7.52 降至 4.02μg/mL（p<0.001）（p<0.001）。此外，添加菊粉后 IS 从 3.42（2.53，6.01）μg/mL 降至 2.83（1.67，4.74）μg/mL；∆IS 为-0.64（-1.48，0.00）μg/mL，与对照组相比差异有统计学意义（p=0.004）。干预后炎症指标降低。结论：膳食纤维补充可能降低透析前 CKD 患者的血清 IS 和 PCS 水平，并调节其炎症状态。
