Resistant starch supplementation attenuates inflammation in hemodialysis patients: a pilot study

Int Urol Nephrol. 2020 Mar;52(3):549-555. doi: 10.1007/s11255-020-02392-3. Epub 2020 Feb 1.

Abstract

Purpose: In chronic kidney disease (CKD) patients, dysbiosis is associated with inflammation and cardiovascular risk, so many nutritional strategies are being studied to reduce these complications. Resistant starch (RS) can be considered a prebiotic that promotes many benefits, including modulation of gut microbiota which is linked to immune-modulatory effects. The aim of this study was to evaluate the effects of RS supplementation on proinflammatory cytokines in CKD patients on hemodialysis (HD).

Methods: A double-blind, placebo-controlled, randomized trial was conducted with sixteen HD patients (55.3 ± 10.05 years, body mass index (BMI) 25.9 ± 5.42 kg/m2, 56% men, time on dialysis 38.9 ± 29.23 months). They were allocated to the RS group (16 g RS/day) or placebo group (manioc flour). The serum concentration of ten cytokines and growth factors was detected through a multiparametric immunoassay based on XMap-labeled magnetic microbeads (Luminex Corp, USA) before and after 4 weeks with RS supplementation.

Results: After RS supplementation, there was a reduction of Regulated upon Activation, Normal T-Cell Expressed and Secreted (p < 0.001), platelet-derived growth factor (two B subunits) (p = 0.014) and interferon-inducible protein 10 (IP-10) (p = 0.027). The other parameters did not change significantly.

Conclusion: This preliminary result indicates that RS may contribute to a desirable profile of inflammatory markers in CKD patients.

Keywords: Chronic kidney disease; Cytokines; Hemodialysis; Inflammation; Resistant starch.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cytokines / analysis
  • Double-Blind Method
  • Dysbiosis* / etiology
  • Dysbiosis* / microbiology
  • Dysbiosis* / prevention & control
  • Female
  • Gastrointestinal Microbiome* / drug effects
  • Gastrointestinal Microbiome* / physiology
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / therapeutic use
  • Male
  • Middle Aged
  • Prebiotics
  • Renal Dialysis / adverse effects*
  • Renal Dialysis / methods
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / immunology
  • Renal Insufficiency, Chronic* / therapy
  • Resistant Starch / administration & dosage*
  • Treatment Outcome

Substances

  • Cytokines
  • Immunologic Factors
  • Prebiotics
  • Resistant Starch