ESPN 53rd Annual Meeting

ESPN 2021


 
DIETARY FIBRE INTAKE IS ASSOCIATED WITH SERUM LEVELS OF URAEMIC TOXINS IN CHILDREN WITH CHRONIC KIDNEY DISEASE
AMINA EL AMOURI 1 EVELIEN SNAUWAERT 1 AURĂ©LIE FOULON 2 CHARLOTTE VANDE MOORTEL 2 Maria Van Dyck 3 Koen Van Hoeck 4 Nathalie Godefroid 5 GRIET GLORIEUX 2 WIM VAN BIESEN 2 JOHAN VANDE WALLE 1 ANN RAES 1 SUNNY ELOOT 2

1- PAEDIATRIC NEPHROLOGY, GHENT UNIVERSITY HOSPITAL
2- NEPHROLOGY, GHENT UNIVERSITY HOSPITAL
3- Paediatric Nephrology, University Hospitals Leuven
4- Paediatric Nephrology, Antwerp University Hospital
5- Paediatric Nephrology, Cliniques Universitaires St. Luc
 
Introduction:

Unbalanced colonic microbial metabolism plays a pivotal role in generating protein-bound uraemic toxins (PBUTs), accumulating with deteriorating kidney function and contributing to the uraemic burden of children with chronic kidney disease (CKD). Dietary choices impact the gut microbiome and metabolism. Our aim was to investigate the relation between dietary fibre and gut-derived PBUTs in paediatric CKD.

Material and methods:

Sixty-one (44 male) CKD children 9 [5;14] years were prospectively followed at 3-month intervals for 2 years. Dietary fibre intake was evaluated by either 24-h recalls (73%) or 3-day food records (27%) at the same time of blood sampling for assessment of total and free serum levels of different PBUTs (mg/dL) using liquid chromatography. Linear mixed models for (natural) log-transformed plasma concentrations were fitted with a random intercept for the patient and with fibre intake (g/day), protein intake (g/day), BSA as a proxy for age (m²), eGFR (mL/min/1.73 m²) to assess associations between fibre intake and PBUT levels.

Results:

For every g/day increase in fibre consumption, mixed-model analysis revealed a 1.6% [ −3.0%; −0.3%] lower total IAA concentration (p = 0.020), whereas free IAA levels were 6.6% [−9.3%; −3.7%] (p < 0.001) lower. Total pCG levels were 3.0% [−5.6%; −0.5%] (p = 0.021) lower, and free serum pCG 3.3% [−5.8%; −0.8%] (p = 0.010) lower per g/day increase in daily fibre consumption. For every gram of increment in daily fibre intake, free IxS levels were 3.1% [−5.9%; −0.3%] (p = 0.035) lower, and free pCS were 2.5% [−4.7%; −0.3%] (p = 0.034) lower. In contrast, total IxS and pCS serum concentrations were not associated with daily fibre intake. 

Conclusions:

The observed associations between dietary fibre intake and the investigated PBUTs highlight potential benefits of fibre intake in the paediatric CKD population. The present observational findings should inform and guide adaptations of dietary prescriptions in children with CKD.