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Article

An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients

1
Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70124 Bari, Italy
2
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
3
Department of Biomedical Sciences and Human Oncology, Clinica Medica “A. Murri”, Medical School, University of Bari “Aldo Moro”, 70124 Bari, Italy
4
Centro Studi e Ricerche Dr. Sergio Fontana (1900–1982), 76012 Canosa, Italy
5
Department of Soil, Plant and Food Science, University of Bari “Aldo Moro”, 70126 Bari, Italy
*
Author to whom correspondence should be addressed.
These two authors equally contributed to the work.
Received: 24 March 2021 / Revised: 2 May 2021 / Accepted: 3 May 2021 / Published: 5 May 2021
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins)
Proteolytic dysbiosis of the gut microbiota has been recognized as both a typical feature of chronic kidney disease (CKD) and a risk factor for its progression. Blood accumulation of gut-derived uremic toxins (UTs) like indoxyl sulfate (IS) and p-cresyl sulfate (PCS), intestinal permeability and constipation are typical features accompanying CKD progression and triggering chronic inflammation. In order to verify the efficacy of the innovative synbiotic formulation NATUREN G® in modulating the levels of circulating UTs, intestinal permeability and gastrointestinal symptoms, we set up a randomized, single-blind, placebo-controlled, pilot trial in stage IIIb-IV CKD patients and in healthy controls. Two-month administration of the synbiotic resulted in a decrease of free IS, as compared with the placebo-treated arm, only in the CKD group. The other UTs did not significantly change, although different trends in time (increase in the placebo arm and decrease in the synbiotic arm) were observed. Moreover, after supplementation, reduction of small intestinal permeability and amelioration of abdominal pain and constipation syndromes were observed only in the CKD group. The obtained results suggest the specificity of action of NATUREN G® in CKD and justify further validation in a wider study population. View Full-Text
Keywords: chronic kidney disease; uremic toxins; intestinal permeability; indoxyl sulfate; randomized pilot trial; synbiotic; gut microbiota chronic kidney disease; uremic toxins; intestinal permeability; indoxyl sulfate; randomized pilot trial; synbiotic; gut microbiota
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MDPI and ACS Style

Cosola, C.; Rocchetti, M.T.; di Bari, I.; Acquaviva, P.M.; Maranzano, V.; Corciulo, S.; Di Ciaula, A.; Di Palo, D.M.; La Forgia, F.M.; Fontana, S.; De Angelis, M.; Portincasa, P.; Gesualdo, L. An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients. Toxins 2021, 13, 334. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13050334

AMA Style

Cosola C, Rocchetti MT, di Bari I, Acquaviva PM, Maranzano V, Corciulo S, Di Ciaula A, Di Palo DM, La Forgia FM, Fontana S, De Angelis M, Portincasa P, Gesualdo L. An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients. Toxins. 2021; 13(5):334. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13050334

Chicago/Turabian Style

Cosola, Carmela, Maria T. Rocchetti, Ighli di Bari, Paola M. Acquaviva, Valentina Maranzano, Simone Corciulo, Agostino Di Ciaula, Domenica M. Di Palo, Flavia M. La Forgia, Sergio Fontana, Maria De Angelis, Piero Portincasa, and Loreto Gesualdo. 2021. "An Innovative Synbiotic Formulation Decreases Free Serum Indoxyl Sulfate, Small Intestine Permeability and Ameliorates Gastrointestinal Symptoms in a Randomized Pilot Trial in Stage IIIb-IV CKD Patients" Toxins 13, no. 5: 334. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13050334

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