Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Division of Nephrology, Department of Internal Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
Hypertens Res. 2024 Nov;47(11):3214-3224. doi: 10.1038/s41440-024-01895-1. Epub 2024 Sep 19.
Cardiovascular diseases (CVDs) are a major cause of death in patients undergoing hemodialysis (HD). Blood pressure (BP) and uremic toxins are well-known risk factors for CVDs, which are influenced by diet. Dietary fiber supplementation in patients undergoing HD may reduce the risk of CVDs by improving lipid profiles and inflammatory status and lowering the levels of the uremic toxin indoxyl sulfate (IS). In this study, we investigated the relationship between the intestinal microbiota and risk factors for CVDs, such as BP and serum IS, in patients undergoing HD who consumed fruits granola (FGR). The study participants were selected from patients undergoing HD at the Izu Nagaoka Daiichi Clinic and consumed FGR for 2 months. Body composition and blood samples were tested at months 0, 1, 2 and fecal samples were collected at months 0 and 2 for intestinal microbiota analysis. FGR consumption decreased systolic and diastolic BP, estimated salt intake, and serum IS levels and improved the stool characteristics according to the Bristol Stool Form Scale (N = 24). Gut microbiota analysis showed an increase in the alpha diversity and abundance of Blautia and Neglecta. The abundance of lactic acid- and ethanol-producing bacteria also significantly increased, whereas the abundance of indole-producing bacteria significantly decreased. FGR consumption could be a useful tool for salt reduction, fiber supplementation, and improvement of the intestinal environment, thus contributing to improvement of BP and the reduction of other risk factors for CVDs in patients undergoing HD.
心血管疾病 (CVDs) 是接受血液透析 (HD) 治疗的患者死亡的主要原因。血压 (BP) 和尿毒症毒素是 CVDs 的已知危险因素，它们受饮食影响。接受 HD 治疗的患者补充膳食纤维可能通过改善血脂谱和炎症状态以及降低尿毒症毒素吲哚硫酸酯 (IS) 的水平来降低 CVDs 的风险。在这项研究中，我们研究了肠道微生物群与 CVDs 的危险因素（如 BP 和血清 IS）之间的关系，这些患者接受 HD 治疗并食用水果格兰诺拉麦片 (FGR)。研究参与者选自在伊豆长冈第一诊所接受 HD 治疗的患者，并食用 FGR 达 2 个月。在 0 个月、1 个月、2 个月时测试身体成分和血液样本，并在 0 个月和 2 个月时采集粪便样本进行肠道微生物群分析。FGR 的摄入降低了收缩压和舒张压、估计盐摄入量以及血清 IS 水平，并根据布里斯托粪便形态量表改善了粪便特征 (N = 24)。肠道微生物群分析显示 α多样性和 Blautia 和 Neglecta 的丰度增加。产乳酸和乙醇的细菌的丰度也显著增加，而吲哚产生菌的丰度显著降低。FGR 的摄入可能是减少盐、补充纤维和改善肠道环境的有用工具，从而有助于改善 HD 患者的血压和降低 CVDs 的其他危险因素。
