Diet is one of the largest modifiable risk factors for chronic kidney disease (CKD)-related death and disability. A recent study suggests that dietary fibre, also known as roughage reduces the uremic toxins levels in Chronic Kidney Disease (CKD) patients. The study findings were published in the Journal of Renal Nutrition on March 16, 2020.
The results of previously published meta-analyses showed that dietary fibre could reduce the levels of p-cresyl sulfate, blood urea nitrogen, and creatinine in patients with chronic kidney disease (CKD). However, these results were based on some trials with pre-post design and randomized controlled trials of low quality. Additionally, it has been suggested that the dosage and duration of fibre supplementation and patients' characteristics potentially influence the effect of dietary fibre in reducing uremic toxins, but it would appear that no research has provided reliable evidence. Therefore, Dr Xiao-Hua Wang, PhD and his team conducted a study to investigate the role of dietary fibre supplements among CKD patients.
In this meta-analysis, researchers searched d PubMed, Web of Science, and Cochrane Library and included a total of 10 randomized controlled trials involving 292 patients with CKD. The researchers pooled the data by the generic inverse variance method using random-effects models and expressed it as a standardized mean difference (SMD) with a 95% confidence interval (CI). Heterogeneity was quantified by I2.
Key findings of the study were:
Upon analysis, researchers identified that dietary fiber supplementation can significantly reduce the levels of:
♦indoxyl sulfate (SMD = −0.55, 95% CI = −1.04, −0.07, P = .03),
♦p-cresyl sulfate (SMD = −0.47, 95% CI = −0.82, −0.13, P < .01),
♦blood urea nitrogen (SMD = −0.31, 95% CI = −0.58, −0.03, P = .03), and
♦uric acid (SMD = −0.60, 95% CI = −1.02, −0.18, P < .01),
♦but not on reducing creatinine (SMD = −0.31, 95% CI = −0.73, 0.11, P = .14).
In subgroup analyses,they noted that the reduction of indoxyl sulfate was more obvious among patients on dialysis than patients not on dialysis.
They also noted that the reduction of creatinine was more obvious among patients without diabetes than those with diabetes.
The authors concluded, "This meta-analysis indicates that dietary fibre supplementation can significantly reduce the levels of uremic toxins in patients with CKD, with evidence for a more obvious effect of patients on dialysis and without diabetes."
They further added, "These findings inform recommendations for using dietary fibre to reducing the uremic toxin among CKD patients in clinical practice."
For further information:
https://www.jrnjournal.org/article/S1051-2276(20)30291-0/fulltext