Fermentable carbohydrate exerts a urea-lowering effect in normal and nephrectomized rats.

The influence of nondigestible carbohydrate on intestinal fermentations and on the route of nitrogen excretion has been investigated in normal rats and in unilaterally nephrectomized rats. Rats were adapted to 10% casein diets, either fiber free or containing different levels of two fermentable carbohydrates, inulin or crude potato starch. Ingestion of fermentable carbohydrate led to a considerable enlargement of the cecum because of hypertrophy of the cecal wall and an increase in cecal contents. Cecal digesta contained elevated concentrations of short-chain fatty acids, resulting in acidic pH. Diets containing fermentable carbohydrate enhanced fecal nitrogen excretion, which was more than doubled at the highest level of inulin or potato starch. In parallel, urinary nitrogen excretion was significantly decreased by fermentable carbohydrate. Although these changes were similar in all animals, there were quantitative differences in the response of nephrectomized animals to fermentable carbohydrate. In nephrectomized rats, plasma urea concentrations were more than 2.5 times higher than in normal rats (5.8 mM compared with 2.2 mM). Plasma urea concentrations were reduced by approximately 50% when normal rats were fed diets containing 7.5-15% inulin or 10-20% resistant starch. In nephrectomized animals fed the highest level of fermentable carbohydrate, plasma urea concentrations were also significantly decreased, but only by 30%. In nephrectomized rats, the concentration of nitrogen cycling in the cecum was greater (urea nitrogen transfer into the cecum was 50-60% greater and ammonia flux from the cecal lumen to the blood was two times higher than in normal rats), but fecal nitrogen excretion was equivalent in normal and nephrectomized animals. When expressed as a percentage of total nitrogen excretion, fecal nitrogen excretion was <20% in animals fed fiber-free diets, compared with 45-50% in normal animals and 40% in nephrectomized animals fed fermentable carbohydrate.