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Int Urol Nephrol. 2017 Apr;49(4):717-725. doi: 10.1007/s11255-016-1495-5. Epub 2017 Jan 2.

Relationship between plasma levels of zonulin, bacterial lipopolysaccharides, D-lactate and markers of inflammation in haemodialysis patients.

Author information

1
Pathophysiology Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Street, 40-752, Katowice, Poland.
2
Health Promotion and Obesity Management Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
3
Department of Nephrology, Transplantation and Internal Medicine, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
4
Dialysis Center in Rybnik, Regional Specialist Hospital No. 3 in Rybnik, Rybnik, Poland.
5
Dialysis Center in Tychy, Centrum Dializa Sosnowiec, Tychy, Poland.
6
Dialysis Center in Pszczyna, Centrum Dializa Sosnowiec, Pszczyna, Poland.
7
Dialysis Center in Siemianowice Śląskie, Nefrolux, Siemianowice Śląskie, Poland.
8
Dialysis Center in Katowice, Centrum Dializa Sosnowiec, Katowice, Poland.
9
Dialysis Center in Chorzów, Centrum Dializa Sosnowiec, Chorzów, Poland.
10
Dialysis Center in Żory, Centrum Dializa Sosnowiec, Żory, Poland.
11
Dialysis Center in Wodzisław Śląski, Centrum Dializa Sosnowiec, Wodzisław Śląski, Poland.
12
Dialysis Center in Sosnowiec, Centrum Dializa Sosnowiec, Sosnowiec, Poland.
13
Pathophysiology Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, Medyków 18 Street, 40-752, Katowice, Poland. chj@poczta.fm.

Abstract

BACKGROUND:

Increased permeability of the intestinal wall and intestinal dysbiosis may contribute to chronic systemic inflammation, one of the causes of accelerated atherosclerosis and cardiovascular morbidity and mortality burden in patients with chronic kidney disease. The aim of this study was to evaluate the association between markers of intestinal permeability and inflammation in haemodialysis (HD) patients.

METHODS:

Plasma concentration of zonulin, haptoglobin, TNFα, IL6, D-lactates and bacterial lipopolysaccharides (LPS) was assessed in blood samples obtained after overnight fast before midweek morning HD session in 150 stable, prevalent HD patients. Daily intake of energy and macronutrients was assessed on the basis of a food frequency questionnaire.

RESULTS:

Serum hsCRP level was increased in over 70% of patients. Plasma levels of zonulin [11.6 (10.9-12.3) vs 6.8 (5.8-7.8) ng/mL], IL6 [6.2 (1.0-10.3) vs 1.3 (1.0-2.0) pg/mL] and TNFα [5.9 (2.9-11.8) vs 1.6 (1.3-1.8) pg/mL], but not LPS and D-lactates were significantly higher in HD than in healthy controls. D-lactates and LPS levels were weakly associated with IL6 (R = 0.175; p = 0.03, and R = 0.241; p = 0.003). There was a borderline correlation between plasma zonulin and serum hsCRP (R = 0.159; p = 0.07), but not with IL6, LPS and D-lactates. In multiple regression, both serum CRP and plasma IL6 variability were explained by LPS (β = 0.143; p = 0.08 and β = 0.171; p = 0.04, respectively), only.

CONCLUSION:

The weak association between plasma D-lactate, LPS and IL6 levels indicates that intestinal flora overgrowth or increased intestinal permeability contributes very slightly to the chronic inflammation development in HD patients.

KEYWORDS:

Chronic renal failure; D-Lactate; Haemodialysis; Inflammation; Intestinal permeability; Zonulin

PMID:
28044237
PMCID:
PMC5357507
DOI:
10.1007/s11255-016-1495-5
[Indexed for MEDLINE]
Free PMC Article

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