Dietary Maneuvers to Reduce Production of Colon-Derived Uremic Solutes

通过饮食调整来减少结肠源性尿毒症溶质的产生

• 批准号: 7791466
• 负责人: TIMOTHY W MEYER
• 金额: $ 29.58万
• 依托单位: PALO ALTO VETERANS INSTIT FOR RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7791466
• 关键词: Biological Assay; Chemicals; Colon; Complement; Cresol; Cresols; Dialysis patients; Dialysis procedure; Diet; Dimethylamines; Edible Plants; End stage renal failure; Excision; Fiber; Follow-Up Studies; Frequencies; Genus Cola; Goals; Health; Hemodialysis; Hour; Indican; Inorganic Sulfates; Intake; Knowledge; Life; Outcome; Patients; Production; Research Personnel; Residual state; Testing; Time; Unspecified or Sulfate Ion Sulfates; Vegetarian diet; base; dimethylamine; improved; public health relevance; solute; wasting

DESCRIPTION (provided by applicant): Hemodialysis prolongs life but does not restore normal health in patients with end stage renal disease. Much of the residual illness suffered by these patients is due to retained "uremic" waste solutes which are not adequately removed by conventional dialysis. Efforts are underway to improve solute removal by increasing the frequency and duration of dialysis treatments. But increasing the number of hours/week on dialysis, even if it affords some benefit, would be both burdensome and costly. This proposal will explore the alternate possibility that uremic solute levels can be lowered by dietary manipulations which reduce solute production. Some potentially important uremic solutes are made in the colon, and the investigators have found that the production of these solutes is greatly reduced in people adhering to a vegetarian diet. Based on this preliminary finding, the investigators propose to test the effect of carefully selected dietary manipulations on solute production in hemodialysis patients. Chemical assays will show whether these manipulations reduce production of the colon-derived uremic solutes p- cresol sulfate, indoxyl sulfate, and dimethylamine. Identification of a dietary treatment that reduced solute production would prompt a follow-up study to test the ability of that treatment to improve health outcomes. The investigators believe that over the long term, diet can compliment dialysis to improve patients' health without an increase in dialysis time. PUBLIC HEALTH RELEVANCE: Conventional hemodialysis prolongs life but does not restore normal health in patients with end stage renal disease. Much of the residual illness suffered by these patients is due to retained waste chemicals which are not adequately removed by current dialysis treatment. This study will assess whether the production of these waste chemicals can be reduced by altering the diet. Finding a dietary change that reduces waste chemical production could provide a means for improving the health of dialysis patients without increasing the time they spend on the dialysis machine.

描述(申请人提供)：血液透析可延长终末期肾病患者的生命，但不能恢复正常健康。这些患者的大部分残留疾病是由于残留的尿毒症废溶质，而传统透析不能充分去除这些溶质。正在努力通过增加透析治疗的频率和持续时间来改善溶质去除。但是，增加每周透析的小时数，即使它提供了一些好处，也会带来负担和代价。这项建议将探索另一种可能性，即尿毒症溶质水平可以通过减少溶质产生的饮食控制来降低。一些潜在的重要尿毒症溶质是在结肠中产生的，研究人员发现，在坚持素食的人中，这些溶质的产生大大减少。基于这一初步发现，研究人员建议测试精心选择的饮食操作对血液透析患者溶质产生的影响。化学分析将显示这些操作是否减少了结肠衍生尿毒症溶液对甲酚硫酸盐、吲哚硫酸盐和二甲胺的产生。确定一种减少溶质产生的饮食治疗将促使进行后续研究，以测试该治疗方法改善健康结果的能力。研究人员认为，从长远来看，饮食可以补充透析，在不增加透析时间的情况下改善患者的健康。 公共卫生相关性：终末期肾病患者的常规血液透析可以延长生命，但不能恢复正常健康。这些患者的大部分残留疾病是由于残留的废化学物质，而目前的透析治疗没有充分去除这些化学物质。这项研究将评估是否可以通过改变饮食来减少这些废物化学物质的产生。找到一种减少废物化学物质产生的饮食改变，可以为改善透析患者的健康提供一种手段，而不会增加他们在透析机上花费的时间。