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Bacterial by-product linked to chronic kidney disease

Posted:  Friday, February 06, 2015

American researchers have discovered that a specific metabolite, namely trimethylamine N-oxide (TMAO) may lead to chronic kidney disease (CKD). The metabolite is produced by the gut bacteria during the digestion of choline and carnitine, nutrients derived from red meat, egg and high fat dairy products.

Published in the journal Circulation Research, the study measured fasting TMAO levels in 521 patients with CKD and in 3,166 subjects without CKD for 5 years. They found that patients with CKD had high TMAO levels and that the latter was associated with greater mortality risk among both the patient groups.

The researchers found that in animals, chronic dietary exposures to choline and TMAO were associated with the development and progression of chronic kidney disease. Elevated plasma TMAO levels have also been linked to future risks of cardiovascular disease (CVD).

Chronic kidney disease is characterised by gradual loss of kidney function over time. Without intervention, this disease could be fatal as it results in the accumulation of waste metabolites in the blood. Studies have shown that patients with CKD are at risk of developing CVD but the exact mechanisms are not known. The relationship between diet and renal disease progression has also not been explored sufficiently.

Discussing the study results, the researchers said, “Elevated plasma TMAO levels in subjects are linked to future cardiac risks, and in subjects with normal renal function, elevated levels predict long-term future risk for development of chronic kidney disease; animal model studies show that long-term exposure to higher levels of TMAO promotes renal functional impairment and atherosclerosis; and as the kidneys lose function, TMAO isn't eliminated as easily, and levels further rise, increasing cardiovascular and kidney disease risks further."

Although these study findings need to be further corroborated by other studies, they have raised the exciting prospects of nutritional interventions to help retard the development and progression of chronic kidney disease. They have also opened up an area of research on curbing gut microbiota-dependent TMAO pathways which are implicated in many conditions.

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