Over 10% of the adult pong causes of end-stage kidney disease are due to type II diabetes and hypertension. There can also be a dysbiosis of the gut microbiome along with inflammation and oxidative stress that can play a role as well. In addition, environmental toxins and proton pump inhibitor (PPI) use have also been linked to CKD.

According to a new study published in Nutrition & Metabolism, researchers demonstrated the benefit of resistant starch on traditional kidney laboratory biomarkers.

A high fiber diet leads to the production of short chain fatty acids (SCFAs) in the gastrointestinal tract. These play an essential role in T regulatory cell activation, which regulates the intestinal immune system. If there is dysregulation in the immune system, there can be increase inflammation seen in CKD.

Previous research has demonstrated that a high fiber diet can mitigate disease severity and kidney dysfunction in patients with CKD.

This study was a double-blinded randomized clinical trial consisting of 50 patients in end stage renal disease. There were 25 patients in each group that either took a resistant starch enriched diet or placebo over an 8-week period.  This was 20-25 gram, 60% resistant starch cracker or a 20-25 gram, waxy corn starch, cracker. Each participant received a 20 gram cracker the first 4 weeks followed by a 25 gram cracker the remainder of the study. Laboratory assessment of BUN, creatinine, uric acid, hemoglobin, hemocrit, uric acid, hs-crp, p-cresol, indoxyl sulfate, and bone markers were measured at baseline and at the end of the study.

As a result, there was a significant reduction of creatinine, uric acid, and p-cresol levels in the resistant starch group. There was not a significant change in the other parameters.

There were no side effects including gastrointestinal intolerance with the recommended doses of resistant starch. Based on these results as well as the safety of diet with resistant starch, it makes sense that this a great addition in the treatment of chronic kidney disease. Other nutrients to consider include fish oil, phosphatidylcholine, and n-acetyl-cysteine or glutathione.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Khosroshahi HT, Abedi B, et al. Effects of fermentable high fiber diet supplementation on gut derived and conventional nitrogenous product in patients on maintenance hemodialysis: a randomized controlled trial. Nutr Metab (Lond). 2019 Mar 12;16:18.



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