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2017 ; 9
(5
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Nutrients Turned into Toxins: Microbiota Modulation of Nutrient Properties in
Chronic Kidney Disease
#MMPMID28498348
Fernandez-Prado R
; Esteras R
; Perez-Gomez MV
; Gracia-Iguacel C
; Gonzalez-Parra E
; Sanz AB
; Ortiz A
; Sanchez-Niņo MD
Nutrients
2017[May]; 9
(5
): ä PMID28498348
show ga
In chronic kidney disease (CKD), accumulation of uremic toxins is associated with
an increased risk of death. Some uremic toxins are ingested with the diet, such
as phosphate and star fruit-derived caramboxin. Others result from nutrient
processing by gut microbiota, yielding precursors of uremic toxins or uremic
toxins themselves. These nutrients include l-carnitine,
choline/phosphatidylcholine, tryptophan and tyrosine, which are also sold
over-the-counter as nutritional supplements. Physicians and patients alike should
be aware that, in CKD patients, the use of these supplements may lead to
potentially toxic effects. Unfortunately, most patients with CKD are not aware of
their condition. Some of the dietary components may modify the gut microbiota,
increasing the number of bacteria that process them to yield uremic toxins, such
as trimethylamine N-Oxide (TMAO), p-cresyl sulfate, indoxyl sulfate and indole-3
acetic acid. Circulating levels of nutrient-derived uremic toxins are associated
to increased risk of death and cardiovascular disease and there is evidence that
this association may be causal. Future developments may include maneuvers to
modify gut processing or absorption of these nutrients or derivatives to improve
CKD patient outcomes.