Synbiotic meal decreases uremic toxins in hemodialysis individuals: A placebo-controlled trial

Generation of uremic toxins p-cresylsulfate (p-CS), indoxyl sulfate (IS) and indole 3-acetic acid (IAA) in hemodialysis (HD) individuals may be associated with the gut flora and recognized markers of disease progression. This study investigated the effect of synbiotic meal on uremic toxins in HD individuals. We conducted randomized singleblind and placebo-controlled intervention study with 58 HD subjects (20F/38M, 63.1 ± 10.9-old) who were randomly allocated in synbiotic group (SG, 40g of extruded sorghum plus 100mL of unfermented probiotic milk) or control group (CG, 40g of extruded corn plus 100mL of pasteurized milk), during 7-wk Metabolic markers anduremictoxins,fecalconcentration ofshortchainfattyacidandpHvalue wasdetermined. The SG group had decreased serum p-CS and IS, as well as decreased urea concentration (p < .05) compared to CG. SG showed higher fecal butyric acid and lower pH compared to baseline and SC (p < .05). In addition, serum p-CS and fecal pH were positively correlated to urea concentration in SG participants at the endpoint. The consumption of the synbiotic meal during 7-wk reduced colonic pH, and reduced serum uremic (p-CS and IS) toxins and urea in HD subjects.