Jean Christ Cédras Capo-Chichi1, Natália Alvarenga Borges2,3, Drielly Cristhiny Mendes de Vargas Reis4, Lia S Nakao5, Denise Mafra6,7. 1. Post Graduation Program in Medical Sciences (UFF), Federal Fluminense University, Unidade de Pesquisa Clínica. Rua Marquês do Paraná, 303, Niterói, Rio de Janeiro, 24033-900, Brazil. 2. Institute of Nutrition, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil. 3. Post-Graduation Program in Cardiovascular Sciences, (UFF), Federal Fluminense University, Niterói, Rio de Janeiro, Brazil. 4. Division of Nephrology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. 5. Department of Basic Pathology, Federal University of Paraná (UFPR), Curitiba, PR, Brazil. 6. Post Graduation Program in Medical Sciences (UFF), Federal Fluminense University, Unidade de Pesquisa Clínica. Rua Marquês do Paraná, 303, Niterói, Rio de Janeiro, 24033-900, Brazil. dmafra30@gmail.com. 7. Post-Graduation Program in Cardiovascular Sciences, (UFF), Federal Fluminense University, Niterói, Rio de Janeiro, Brazil. dmafra30@gmail.com.
Abstract
BACKGROUND: Anemia is one of the most frequent complications in patients with chronic kidney disease (CKD). Despite being multifactorial, the relative or absolute deficiency of erythropoietin production is the leading cause. Recent studies have shown that uremic toxins produced by the gut microbiota also may play a role in the genesis of anemia in these patients. OBJECTIVE: To evaluate the possible association between uremic toxins plasma levels and anemia in patients with CKD on hemodialysis (HD). METHODS: This cross-sectional study evaluated one hundred fifty-four patients (53.2% men, 51.2 ± 11.2 years, hemoglobin (Hb) levels of 11.2 ± 1.6 g/dL). Biochemical variables such as urea, creatinine, hemoglobin, hematocrit, were measured according to standard methods and uremic toxins such as indoxyl sulfate (IS), indole-3-acetic acid (IAA), p-cresyl sulfate (p-CS) plasma levels were measured by reverse-phase high-performance liquid chromatography (RP-HPLC). RESULTS: The levels of uremic toxins such as IS, IAA, p-CS were increased in all patients. However, no correlation was found between uremic toxins plasma levels and anemia parameters. Only patients with Hb < 11 g/dL presented a negative correlation between hematocrit and IAA plasma levels. CONCLUSION: There is no strong evidence that uremic toxins produced by the gut microbiota may be associated with anemia in patients with CKD on HD.
BACKGROUND: Anemia is one of the most frequent complications in patients with chronic kidney disease (CKD). Despite being multifactorial, the relative or absolute deficiency of erythropoietin production is the leading cause. Recent studies have shown that uremic toxins produced by the gut microbiota also may play a role in the genesis of anemia in these patients. OBJECTIVE: To evaluate the possible association between uremic toxins plasma levels and anemia in patients with CKD on hemodialysis (HD). METHODS: This cross-sectional study evaluated one hundred fifty-four patients (53.2% men, 51.2 ± 11.2 years, hemoglobin (Hb) levels of 11.2 ± 1.6 g/dL). Biochemical variables such as urea, creatinine, hemoglobin, hematocrit, were measured according to standard methods and uremic toxins such as indoxyl sulfate (IS), indole-3-acetic acid (IAA), p-cresyl sulfate (p-CS) plasma levels were measured by reverse-phase high-performance liquid chromatography (RP-HPLC). RESULTS: The levels of uremic toxins such as IS, IAA, p-CS were increased in all patients. However, no correlation was found between uremic toxins plasma levels and anemia parameters. Only patients with Hb < 11 g/dL presented a negative correlation between hematocrit and IAA plasma levels. CONCLUSION: There is no strong evidence that uremic toxins produced by the gut microbiota may be associated with anemia in patients with CKD on HD.
Authors: Amanda J Wong; Stephen R Planck; Dongseok Choi; Christina A Harrington; Megan L Troxell; Donald C Houghton; Patrick Stauffer; David J Wilson; Hans E Grossniklaus; Roger A Dailey; John D Ng; Eric A Steele; Gerald J Harris; Craig Czyz; Jill A Foster; Valerie A White; Peter J Dolman; Michael Kazim; Payal J Patel; Deepak P Edward; Hind al Katan; Hailah al Hussain; Dinesh Selva; R Patrick Yeatts; Bobby S Korn; Don O Kikkawa; James T Rosenbaum Journal: PLoS One Date: 2014-10-10 Impact factor: 3.240
Authors: Gunnar Toft; Uffe Heide-Jørgensen; Heleen van Haalen; Glen James; Katarina Hedman; Henrik Birn; Christian F Christiansen; Reimar W Thomsen Journal: J Nephrol Date: 2019-10-05 Impact factor: 3.902