PMID- 38093628 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20240106 IS - 2042-650X (Electronic) IS - 2042-6496 (Linking) VI - 15 IP - 1 DP - 2024 Jan 2 TI - The arsenic-lowering effect of inulin-type prebiotics in end-stage renal disease: a randomized crossover trial. PG - 355-371 LID - 10.1039/d3fo01843a [doi] AB - Background: Circulatory imbalance of trace elements is frequent in end-stage renal disease (ESRD), leading to a deficiency of essential elements and excess of toxic elements. The present study aimed to investigate whether inulin-type fructans (ITFs) could ameliorate the circulatory imbalance by modulating gut microbiota and regulating the absorption and elimination of trace elements. Methods: Peritoneal dialysis patients were enrolled in a randomized crossover trial, undergoing interventions with ITFs (10 g d(-1)) and maltodextrin (placebo) over a 9-month period (with a 3-month washout). The primary outcomes included essential elements Mn, Fe, Co, Cu, Zn, Se, Sr, and Mo and potential toxic elements V, Cr, Ni, As, Cd, Ba, Tl, Pb, Th, and U in plasma. Secondary outcomes included the gut microbiome, short chain fatty acids (SCFAs), bile acids (BAs), and daily removal of trace elements through urine, dialysate and feces. Results: Among the 44 participants initially randomized, 29 completed the prebiotic, placebo or both interventions. The daily dietary intake of macronutrients and trace elements remained consistent throughout the study. The administration of 10 g d(-1) ITFs significantly reduced plasma arsenic (As) by 1.03 mug L(-1) (95%CI: -1.74, -0.33) (FDR-adjusted P = 0.045) down from the baseline of 3.54 mug L(-1) (IQRs: 2.61-4.40) and increased the As clearance rate by urine and dialysis (P = 0.033). Positive changes in gut microbiota were also observed, including an increase in the Firmicutes/Bacteroidetes ratio (P = 0.050), a trend towards higher fecal SCFAs (P = 0.082), and elevated excretion of primary BAs (P = 0.035). However, there were no significant changes in plasma concentrations of other trace elements or their daily removal by urine, dialysis and feces. Conclusions: The daily administration of 10 g d(-1) ITFs proved to be effective in reducing the circulating retention of As but demonstrated to be ineffective for other trace elements in ESRD. These sentences are ok to include but as "The clinical trial registry number is ChiCTR-INR-17013739 (https://www.chictr.org.cn/showproj.aspx?proj=21228)". FAU - Li, Li AU - Li L AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Zhao, Jing AU - Zhao J AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Wang, Jinxue AU - Wang J AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Xiong, Qianqian AU - Xiong Q AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Lin, Xuechun AU - Lin X AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Guo, Xiaolei AU - Guo X AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Peng, Fan AU - Peng F AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. FAU - Liang, Wangqun AU - Liang W AD - Division of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. FAU - Zuo, Xuezhi AU - Zuo X AD - Department of Clinical Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. zuo1967@tjh.tjmu.edu.cn. FAU - Ying, Chenjiang AU - Ying C AUID- ORCID: 0000-0003-4813-5951 AD - Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. yingcj@hust.edu.cn. LA - eng PT - Journal Article PT - Randomized Controlled Trial DEP - 20240102 PL - England TA - Food Funct JT - Food & function JID - 101549033 RN - 0 (Prebiotics) RN - 9005-80-5 (Inulin) RN - N712M78A8G (Arsenic) RN - 0 (Trace Elements) RN - 0 (Fructans) SB - IM MH - Humans MH - Prebiotics MH - Inulin MH - *Arsenic MH - Cross-Over Studies MH - *Trace Elements MH - *Kidney Failure, Chronic/drug therapy MH - Fructans EDAT- 2023/12/14 06:42 MHDA- 2024/01/03 09:41 CRDT- 2023/12/14 02:53 PHST- 2024/01/03 09:41 [medline] PHST- 2023/12/14 06:42 [pubmed] PHST- 2023/12/14 02:53 [entrez] AID - 10.1039/d3fo01843a [doi] PST - epublish SO - Food Funct. 2024 Jan 2;15(1):355-371. doi: 10.1039/d3fo01843a.