Journal of Renal Nutrition
Volume 16, Issue 1 , Pages 67-74 , January 2006

Fermentable Carbohydrate Supplementation Alters Nitrogen Excretion in Chronic Renal Failure

Presented at the 12th International Congress on Nutrition and Metabolism in Renal Disease, Abano Terme (Padova-Venice), June 19—22, 2004.

  • Hassan Younes, PhD

      Affiliations

    • Department of Nephrology, Hemodialysis Unit, Hotel Dieu, CHU Clermont-Ferrand, France
    • Corresponding Author InformationAddress reprint requests to Hassan Younes, PhD, CHU Clermont-Ferrand, Department of Nephrology, Hemodialysis Unit, Hotel Dieu, Bd. Léon Malfreyt, 63003 Clermont-Ferrand, France
    • ,
  • Nadine Egret, MD

      Affiliations

    • Department of Nephrology, Hemodialysis Unit, Hotel Dieu, CHU Clermont-Ferrand, France
    • ,
  • Mohamed Hadj-Abdelkader, MD

      Affiliations

    • Department of Nephrology, Hemodialysis Unit, Hotel Dieu, CHU Clermont-Ferrand, France
    • ,
  • Christian Rémésy, PhD

      Affiliations

    • Human Nutrition Research Center, Metabolic Diseases and Micronutrients Unit, INRA, Saint-Genes Champanelle, France
    • ,
  • Christian Demigné, PhD

      Affiliations

    • Human Nutrition Research Center, Metabolic Diseases and Micronutrients Unit, INRA, Saint-Genes Champanelle, France
    • ,
  • Claudine Gueret, MD

      Affiliations

    • Department of Nephrology, Hemodialysis Unit, Hotel Dieu, CHU Clermont-Ferrand, France
    • ,
  • Patrice Deteix, MD, PhD

      Affiliations

    • Department of Nephrology, Hemodialysis Unit, Hotel Dieu, CHU Clermont-Ferrand, France
    • ,
  • Jean-Claude Alphonse, MD

      Affiliations

    • Department of Nephrology, Hemodialysis Unit, Hotel Dieu, CHU Clermont-Ferrand, France

References 

  1. Mitch WE . Dietary protein restriction in chronic renal failure (Nutritional efficacy, compliance and progression of renal insufficiency) . J Am Soc Nephrol . 1991;2:823–831
  2. Fouque D , Laville M , Boissel JP , et al.   Controlled low protein diets in chronic renal insufficiency (Meta-analysis) . BMJ . 1992;304:216–220
  3. Pedrini MT , Levey AS , Lau J , et al.   The effect of dietary protein restriction on the progression of diabetic and non-diabetic renal disease (A meta-analysis) . Ann Intern Med . 1996;124:627–632
  4. Levey AS , Adler S , Greene T , et al.   Effects of dietary protein restriction on the progression of moderate renal disease in the Modification of Diet in Renal Disease Study . J Am Soc Nephrol . 1996;7:2616–2626
  5. Mackenzie HS , Brenner BM . Current strategies for retarding progression of renal disease . Am J Kidney Dis . 1998;31:161–170
  6. Aparicio M , Chauveau P , DePrecigout V , et al.   Nutrition and outcome on renal replacement therapy of patients with chronic renal failure treated by a supplemented very low protein diet . J Am Soc Nephrol . 2000;11:708–716
  7. El Nahas AM , Coles GA . Dietary treatment of chronic renal failure (Ten unanswered questions) . Lancet . 1986;1: 597-560
  8. Mitch WE , Maroni BJ . Factors causing malnutrition in patients with chronic uremia . Am J Kidney Dis . 1999;33:176–179
  9. Rampton DS , Cohen SL , Crammond VDB , et al.   Treatment of chronic renal failure with dietary fiber . Clin Nephrol . 1984;21:159–163
  10. Parillo M , Riccardi G , Pacioni D , et al.   Metabolic consequences of feeding a high-carbohydrate, high-fiber diet to diabetic patients with chronic kidney failure . Am J Clin Nutr . 1988;48:255–259
  11. Younes H , Garleb K , Behr S , et al.   Fermentable fibers or oligosaccharides reduce urinary nitrogen excretion by increasing urea disposal in the cecum . J Nutr . 1995;125:1010–1016
  12. Younes H , Remesy C , Behr S , et al.   Fermentable carbohydrate exerts a urea-lowering effect in normal and nephrectomized rats . Am J Physiol . 1997;272:G515–G521
  13. Stephen AM , Dahl WJ , Sieber GM , et al.   Effect of green lentils on colonic function, nitrogen balance, and serum lipids in healthy human subjects . Am J Clin Nutr . 1995;62:1261–1267
  14. Tetens I , Livesey G , Eggum BO . Effects of type and level of dietary fiber supplements on nitrogen retention and excretion patterns . Br J Nutr . 1996;75:461–469
  15. Bliss DZ , Stein TP , Schleifer CR , et al.   Supplementation with gum arabic fiber increases fecal nitrogen excretion and lowers serum urea nitrogen concentration in chronic renal failure patients consuming a low-protein diet . Am J Clin Nutr . 1996;63:392–398
  16. Heijnen ML , Beynen AC . Consumption of retrograded (RS3) but not uncooked (RS2) resistant starch shifts nitrogen excretion from urine to feces in cannulated piglets . J Nutr . 1997;127:1828–1832
  17. Younes H , Demigne C , Behr S , et al.   Resistant starch exerts an uremia lowering effect by enhancing urea disposal in the large intestine . Nutr Res . 1995;15:1199–1210
  18. Younes H , Alphonse JC , Hadj-Abdelkader M , et al.   Fermentable carbohydrate and digestive nitrogen excretion . J Ren Nutr . 2001;11:139–148
  19. Younes H , Alphonse JC , Behr SR , et al.   Role of fermentable carbohydrate supplements with a low protein diet in the course of chronic renal failure (Experimental bases) . Am J Kidney Dis . 1999;4:1–15
  20. Levrat MA , Behr SR , Remesy C , et al.   Effects of soybean fiber on cecal digestion in rats previously adapted to a fiber-free diet . J Nutr . 1991;121:672–678
  21. Remesy C , Behr SR , Levrat MA , et al.   Fiber fermentation in the rat cecum and its physiological consequences . Nutr Res . 1992;12:1235–1244
  22. Cummings JH , Bingham SA , Heaton KW , et al.   Fecal weight, colon cancer risk, and dietary intake of nonstarch polysaccharides (dietary fiber) . Gastroenterology . 1992;103:1783–1789
  23. Bagheri SM , Debry G . Estimation of the average dietary fiber consumption in the French population . Ann Nutr Met . 1991;34:69–75
  24. Maroni BJ . Protein restriction in the pre-end-stage renal disease (ESRD) patient (Who, when, how and the effect on subsequent ESRD outcome) . J Am Soc Nephrol . 1998;9:S100–S106
  25. Walser M , Mitch WE , Maroni BJ , et al.   Should protein intake be restricted in predialysis patients? . Kidney Int . 1999;55:771–777
  26. Mitch WE . Dietary therapy in uremia (The impact on nutrition and progressive renal failure) . Kidney Int . 2000;57:S38–S43
  27. Weber FL , Minco D , Fresard KM , et al.   Effects of vegetable diets on nitrogen metabolism in cirrhotic subjects . Gastroenterology . 1985;89:538–544
  28. Saunders RM , Betschart AA . The significance of protein as a component of dietary fiber . Am J Clin Nutr . 1980;33:960–961
  29. Mariotti F , Epueyo M , Tome D , et al.   Guar gum does not impair the absorption and utilization of dietary nitrogen but affects early endogenous kinetics in humans . Am J Clin Nutr . 2001;74:487–493
  30. Yatzidis H , Koutsicos D , Digenis P . Oral locust bean gum therapy of uremia (Favorable effect on biological abnormalities and hypertension) . Dial Transplant . 1980;9:313–317
  31. Tomlin J . Which fiber is best for the colon? . Scand J Gastroenterol . 1987;22:S100–S104
  32. Sakata T , Engelhardt WV . Influence of short-chain fatty acids on the epithelial cell division of digestive tract . Q J Exp Physiol . 1983;69:639–648
  33. Young GP , Gibson PR . Butyrate and the human cancer cell . In:  Cummings JH ,  Rombeau JL ,  Sakata T editor. Physiological and Clinical Aspects of Short-Chain Fatty Acids . Cambridge, England: Cambridge University Press; 1995;p. 319–336
  34. Demigne C , Remesy C . Influence of unrefined potato starch on cecal fermentations and volatiles fatty acid absorption in rats . J Nutr . 1982;112:2227–2234
  35. Remesy C , Demigne C . Specific effects of fermentable carbohydrates on blood urea flux and ammonia absorption in the rat cecum . J Nutr . 1989;119:560–565
  36. Brown CL , Hill MJ , Richards P . Bacterial ureases in uremic men . Lancet . 1971;1:406–407
  37. Viallard V . Endogenous urea as a nitrogen source for microorganisms of the rabbit digestive tract . Ann Nutr Metab . 1984;28:151–155
  38. Wrong OM , Vince AJ , Waterlow JC . The contribution of endogenous urea to fecal ammonia in man, determined by 15N labeling of plasma urea . Clin Sci . 1985;68:193–199
  39. Stephen AM , Cummings JH . The microbial contribution to human fecal mass . J Med Microbiol . 1980;13:45–56
  40. Stephen AM . Dietary fiber and colonic nitrogen metabolism . Scand J Gastroenterol . 1987;22:S110–S115
  41. Wrick KL , Robertson JB , VanSoat PJ , et al.   The influence of dietary fiber source on human intestinal transit and stool out-put . J Nutr . 1983;113:1464–1479
  42. Sanada H . Study on the clinical effect of rhubarb on nitrogen-metabolism abnormality due to chronic renal failure and its mechanism . Jpn J Nephrol . 1996;38:379–387
  43. Friedman EA . Predicting Nephrology in the 21st century . ASAIO J . 1999;45:363–366
  44. Flourie B . The influence of dietary fiber on carbohydrate digestion and absorption . In:  Schweizer TF ,  Edwards CA editor. Dietary Fiber (a Component of Food) . Springer-Verlag; 1992;p. 181–196
  45. Mortensen B , Holtus K , Bonnen H , et al.   The degradation of amino acids, proteins, and blood to short-chain fatty acids in colon is prevented by lactulose . Gastroenterology . 1990;98:353–360
  46. Cano N , Leverve XM . Metabolism of nutriments during the chronic renal failure . Nutr Clin Metabol . 1997;11:427–438

 Supported by a grant from Bellco France, 9, rue Georges Besse, 92160 Antony, France.

PII: S1051-2276(05)00178-0

doi: 10.1053/j.jrn.2005.10.007

Journal of Renal Nutrition
Volume 16, Issue 1 , Pages 67-74 , January 2006

Article Tools

* Image Usage & Resolution