The intestine and the kidneys: A bad marriage can be hazardous

Clinical Kidney Journal

Volumn 8, Issue 2, 2015, Pages 168-179

  Vanholder, Raymond ^a   Glorieux, Griet ^a  

^a GHENT UNIVERSITY HOSPITAL   (Belgium)

Author keywords

CKD; Creatinine; Haemodialysis; Systematic review; Uraemic toxins

Indexed keywords

ADVANCED GLYCATION END PRODUCT; AMINO ACID; AMMONIA; AST 120; MECLOFENAMIC ACID; OXALIC ACID; PREBIOTIC AGENT; PROBIOTIC AGENT; SEVELAMER; SULFOTRANSFERASE INHIBITOR; SYNBIOTIC AGENT; UREA; UREMIC TOXIN; URIC ACID;

ARTICLE; DIET THERAPY; FECES MICROFLORA; HEMODIALYSIS PATIENT; HUMAN; INTESTINE; INTESTINE ABSORPTION; INTESTINE FLORA; INTESTINE FUNCTION; KIDNEY; KIDNEY FAILURE; METABOLITE; MICROBIAL METABOLISM; NONHUMAN; PATHOPHYSIOLOGY; PRIORITY JOURNAL; PROTEIN INTAKE; RANDOMIZED CONTROLLED TRIAL (TOPIC); SOLUTE; SYSTEMATIC REVIEW (TOPIC); UREMIA; URINARY EXCRETION;

EID: 84942081304     PISSN: 20488505     EISSN: 20488513     Source Type: Journal    
DOI: 10.1093/ckj/sfv004     Document Type: Article

References (131)

1. Turnbaugh PJ, Ley RE, Hamady M et al. The human microbiome project. Nature 2007; 449: 804-810
2. Guarner F, Malagelada JR. Gut flora in health and disease. Lancet 2003; 361: 512-519
3. Choi JJ, Eum SY, Rampersaud E et al. Exercise attenuates PCB-induced changes in the mouse gut microbiome. Environ Health Perspect 2013; 121: 725-730
4. David LA, Maurice CF, Carmody RN et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature 2014; 505: 559-563
5. Lam V, Su J, Koprowski S et al. Intestinal microbiota determine severity of myocardial infarction in rats. FASEB J 2012; 26: 1727-1735
6. Turnbaugh PJ, Ley RE, Mahowald MA et al. An obesityassociated gut microbiome with increased capacity for energy harvest. Nature 2006; 444: 1027-1031
7. Cesaro C, Tiso A, Del Prete A et al. Gut microbiota and probiotics in chronic liver diseases. Dig Liver Dis 2011; 43: 431-438
8. Hopkins MJ, Sharp R, Macfarlane GT. Age and disease related changes in intestinal bacterial populations assessed by cell culture, 16S rRNA abundance, and community cellular fatty acid profiles. Gut 2001; 48: 198-205
9. Turnbaugh PJ, Hamady M, Yatsunenko T et al. A core gut microbiome in obese and lean twins. Nature 2009; 457: 480-484
10. Anders HJ, Andersen K, Stecher B. The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney Int 2013; 83: 1010-1016
11. Evenepoel P, Meijers BK, Bammens BR et al. Uremic toxins originating from colonic microbial metabolism. Kidney Int Suppl 2009; 76(Suppl 114): S12-S19
12. Schepers E, Glorieux G, Vanholder R. The gut: The forgotten organ in uremia? Blood Purif 2010; 29: 130-136
13. Ramezani A, Raj DS. The gut microbiome, kidney disease, and targeted interventions. J Am Soc Nephrol 2014; 25: 657-670
14. Vitetta L, Linnane AW, Gobe GC. From the gastrointestinal tract (GIT) to the kidneys: Live bacterial cultures (probiotics) mediating reductions of uremic toxin levels via free radical signaling. Toxins (Basel) 2013; 5: 2042-2057
15. Massy ZA, Barreto DV, Barreto FC et al. Uraemic toxins for consideration by the cardiologist-Beyond traditional and non-traditional cardiovascular risk factors. Atherosclerosis 2010; 211: 381-383
16. Di Cerbo A, Pezzuto F, Palmieri L et al. Clinical and experimental use of probiotic formulations for management of end-stage renal disease: An update. Int Urol Nephrol 2013; 45: 1569-1576
17. Poesen R, Meijers B, Evenepoel P. The colon: An overlooked site for therapeutics in dialysis patients. Semin Dial 2013; 26: 323-332
18. Glorieux G, Vanholder R, Lameire N. Advanced glycation and the immune system: Stimulation, inhibition or both? Eur J Clin Invest 2001; 31: 1015-1018
19. Koschinsky T, He CJ, Mitsuhashi Tet al. Orally absorbed reactive glycation products (glycotoxins): An environmental risk factor in diabetic nephropathy. Proc Natl Acad Sci USA 1997; 94: 6474-6479
20. Smith EA, MacFarlane GT. Enumeration of amino acid fermenting bacteria in the human large intestine: Effects of pH and starch on peptide metabolism and dissimilation of amino acids. FEMS Microbiol Ecol 1998; 25: 355-368
21. Vaziri ND, Wong J, Pahl M et al. Chronic kidney disease alters intestinal microbial flora. Kidney Int 2013; 83: 308-315
22. Wang F, Jiang H, Shi K et al. Gut bacterial translocation is associated with microinflammation in end-stage renal disease patients. Nephrology (Carlton) 2012; 17: 733-738
23. Strid H, Simren M, Stotzer PO et al. Patients with chronic renal failure have abnormal small intestinal motility and a high prevalence of small intestinal bacterial overgrowth. Digestion 2003; 67: 129-137
24. Wu MJ, Chang CS, Cheng CH et al. Colonic transit time in longterm dialysis patients. Am J Kidney Dis 2004; 44: 322-327
25. Bammens B, Verbeke K, Vanrenterghem Y et al. Evidence for impaired assimilation of protein in chronic renal failure. Kidney Int 2003; 64: 2196-2203
26. Wang IK, Lai HC, Yu CJ et al. Real-time PCR analysis of the intestinal microbiotas in peritoneal dialysis patients. Appl Environ Microbiol 2012; 78: 1107-1112
27. Wong J, Piceno YM, DeSantis TZ et al. Expansion of ureaseand uricase-containing, indole- and p-cresol-forming and contraction of short-chain fatty acid-producing intestinal microbiota in ESRD. Am J Nephrol 2014; 39: 230-237
28. Bossola M, Sanguinetti M, Scribano D et al. Circulating bacterial- derived DNA fragments and markers of inflammation in chronic hemodialysis patients. Clin J Am Soc Nephrol 2009; 4: 379-385
29. de Almeida Duarte JB, de Aguilar-Nascimento JE, Nascimento M et al. Bacterial translocation in experimental uremia. Urol Res 2004; 32: 266-270
30. Wang F, Zhang P, Jiang H et al. Gut bacterial translocation contributes to microinflammation in experimental uremia. Dig Dis Sci 2012; 57: 2856-2862
31. Wei M, Wang Z, Liu H et al. Probiotic Bifidobacterium animalis subsp. lactis Bi-07 alleviates bacterial translocation and ameliorates microinflammation in experimental uraemia. Nephrology (Carlton) 2014; 19: 500-506
32. Magnusson M, Magnusson KE, Sundqvist T et al. Impaired intestinal barrier function measured by differently sized polyethylene glycols in patients with chronic renal failure. Gut 1991; 32: 754-759
33. Vaziri ND, Yuan J, Rahimi A et al. Disintegration of colonic epithelial tight junction in uremia: A likely cause of CKDassociated inflammation. Nephrol Dial Transplant 2012; 27: 2686-2693
34. Vaziri ND, Yuan J, Norris K. Role of urea in intestinal barrier dysfunction and disruption of epithelial tight junction in chronic kidney disease. Am J Nephrol 2013; 37: 1-6
35. Vaziri ND, Yuan J, Khazaeli M et al. Oral activated charcoal adsorbent (AST-120) ameliorates chronic kidney diseaseinduced intestinal epithelial barrier disruption. Am J Nephrol 2013; 37: 518-525
36. Niwa T, Emoto Y, Maeda K et al. Oral sorbent suppresses accumulation of albumin-bound indoxyl sulphate in serum of haemodialysis patients. Nephrol Dial Transplant 1991; 6: 105-109
37. Einheber A, Carter D. The role of the microbial flora in uremia. I. Survival times of germfree, limited-flora, and conventionalized rats after bilateral nephrectomy and fasting. J Exp Med 1966; 123: 239-250
38. Yokoyama MT, Tabori C, Miller ER et al. The effects of antibiotics in the weanling pig diet on growth and the excretion of volatile phenolic and aromatic bacterial metabolites. Am J Clin Nutr 1982; 35: 1417-1424
39. Holler E, Butzhammer P, Schmid K et al. Metagenomic analysis of the stool microbiome in patients receiving allogeneic stem cell transplantation: Loss of diversity is associated with use of systemic antibiotics and more pronounced in gastrointestinal graft-versus-host disease. Biol Blood Marrow Transplant 2014; 20: 640-645
40. Wikoff WR, Anfora AT, Liu J et al. Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites. Proc Natl Acad Sci USA 2009; 106: 3698-3703
41. Wikoff WR, Nagle MA, Kouznetsova VL et al. Untargeted metabolomics identifies enterobiome metabolites and putative uremic toxins as substrates of organic anion transporter 1 (Oat1). J Proteome Res 2011; 10: 2842-2851
42. Aronov PA, Luo FJ, Plummer NS et al. Colonic contribution to uremic solutes. J Am Soc Nephrol 2011; 22: 1769-1776
43. Patel KP, Luo FJ, Plummer NS et al. The production of p-cresol sulfate and indoxyl sulfate in vegetarians versus omnivores. Clin J Am Soc Nephrol 2012; 7: 982-988
44. Ling WH, Hanninen O. Shifting from a conventional diet to an uncooked vegan diet reversibly alters fecal hydrolytic activities in humans. J Nutr 1992; 122: 924-930
45. Sirich TL, Plummer NS, Gardner CD et al. Effect of increasing dietary fiber on plasma levels of colon-derived solutes in hemodialysis patients. Clin J AmSoc Nephrol 2014; 9: 1603-1610
46. Eloot S, Van Biesen W, Glorieux G et al. Does the adequacy parameter Kt/V(urea) reflect uremic toxin concentrations in hemodialysis patients? PLoS One 2013; 8: E76838
47. Sirich T, Meyer TW. Indoxyl sulfate: Long suspected but not yet proven guilty. Clin J Am Soc Nephrol 2011; 6: 3-4
48. Vanholder R, Schepers E, Pletinck A et al. The uremic toxicity of indoxyl sulfate and p-cresyl sulfate: A systematic review. J Am Soc Nephrol 2014; 25: 1897-1907
49. Barreto FC, Barreto DV, Liabeuf S et al. Serum indoxyl sulfate is associated with vascular disease and mortality in chronic kidney disease patients. Clin J Am Soc Nephrol 2009; 4: 1551-1558
50. Chiu CA, Lu LF, Yu TH et al. Increased levels of total PCresylsulphate and indoxyl sulphate are associated with coronary artery disease in patients with diabetic nephropathy. Rev Diabet Stud 2010; 7: 275-284
51. Liabeuf S, Barreto DV, Barreto FC et al. Free p-cresylsulphate is a predictor of mortality in patients at different stages of chronic kidney disease. Nephrol Dial Transplant 2010; 25: 1183-1191
52. Wang CP, Lu LF, Yu TH et al. Serum levels of total p-cresylsulphate are associated with angiographic coronary atherosclerosis severity in stable angina patients with early stage of renal failure. Atherosclerosis 2010; 211: 579-583
53. Wu IW, Hsu KH, Lee CC et al. p-Cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. Nephrol Dial Transplant 2011; 26: 938-947
54. Wu IW, Hsu KH, Hsu HJ et al. Serum free p-cresyl sulfate levels predict cardiovascular and all-cause mortality in elderly hemodialysis patients-A Prospective Cohort Study. Nephrol Dial Transplant 2012; 27: 1169-1175
55. Barnes KJ, Rowland A, Polasek TM et al. Inhibition of human drug-metabolising cytochrome P450 and UDP-glucuronosyltransferase enzyme activities in vitro by uremic toxins. Eur J Clin Pharmacol 2014; 70: 1097-1106
56. Pletinck A, Glorieux G, Schepers E et al. Protein-bound uremic toxins stimulate crosstalk between leukocytes and vessel wall. J Am Soc Nephrol 2013; 24: 1981-1994
57. Kim YH, Kwak KA, Gil HW et al. Indoxyl sulfate promotes apoptosis in cultured osteoblast cells. BMC Pharmacol Toxicol 2013; 14: 60
58. Sun CY, Young GH, Hsieh YT et al. Protein-bound uremic toxins induce tissue remodeling by targeting the EGF receptor. J Am Soc Nephrol 2014; doi: 10.1681/ASN 2014010021
59. Ng HY, Yisireyili M, Saito S et al. Indoxyl sulfate downregulates expression of Mas receptor via OAT3/AhR/Stat3 pathway in proximal tubular cells. PLoS One 2014; 9: E91517
60. Jourde-Chiche N, Dou L, Cerini C et al. Protein-bound toxins- update 2009. Semin Dial 2009; 22: 334-339
61. Mutsaers HA, van den Heuvel LP, Ringens LH et al. Uremic toxins inhibit transport by breast cancer resistance protein and multidrug resistance protein 4 at clinically relevant concentrations. PLoS One 2011; 6: E18438
62. Tsujimoto M, Hatozaki D, Shima D et al. Influence of serum in hemodialysis patients on the expression of intestinal and hepatic transporters for the excretion of pravastatin. Ther Apher Dial 2012; 16: 580-587
63. Vanholder R, Van Landschoot N, De Smet R et al. Drug protein binding in chronic renal failure: Evaluation of nine drugs. Kidney Int 1988; 33: 996-1004
64. Chitalia VC, Shivanna S, Martorell J et al. Uremic serum and solutes increase post-vascular interventional thrombotic risk through altered stability of smooth muscle cell tissue factor. Circulation 2013; 127: 365-376
65. Dou L, Sallee M, Cerini C et al. The cardiovascular effect of the uremic solute indole-3 acetic acid. J Am Soc Nephrol 2014; doi 10.1681/ASN 2013121283
66. Gondouin B, Cerini C, Dou L et al. Indolic uremic solutes increase tissue factor production in endothelial cells by the aryl hydrocarbon receptor pathway. Kidney Int 2013; 84: 733-744
67. Mutsaers HA, Wilmer MJ, Reijnders D et al. Uremic toxins inhibit renal metabolic capacity through interference with glucuronidation and mitochondrial respiration. Biochim Biophys Acta 2013; 1832: 142-150
68. Jankowski J, van der Giet M, Jankowski V et al. Increased plasma phenylacetic acid in patients with end-stage renal failure inhibits iNOS expression. J Clin Invest 2003; 112: 256-264
69. Meert N, Schepers E, Glorieux G et al. Novel method for simultaneous determination of p-cresylsulphate and p-cresylglucuronide: Clinical data and pathophysiological implications. Nephrol Dial Transplant 2012; 27: 2388-2396
70. Glorieux G, Helling R, Henle T et al. In vitro evidence for immune activating effect of specific AGE structures retained in uremia. Kidney Int 2004; 66: 1873-1880
71. Uribarri J, Stirban A, Sander D et al. Single oral challenge by advanced glycation end products acutely impairs endothelial function in diabetic and nondiabetic subjects. Diabetes Care 2007; 30: 2579-2582
72. Rossi M, Klein K, Johnson DWet al. Pre-, pro-, and synbiotics: Do they have a role in reducing uremic toxins? A systematic review and meta-analysis. Int J Nephrol 2012; 2012: 673631
73. Lieske JC, Tremaine WJ, De Simone C et al. Diet, but not oral probiotics, effectively reduces urinary oxalate excretion and calcium oxalate supersaturation. Kidney Int 2010; 78: 1178-1185
74. Birkett A, Muir J, Phillips J et al. Resistant starch lowers fecal concentrations of ammonia and phenols in humans. Am J Clin Nutr 1996; 63: 766-772
75. Geboes KP, De Hertogh G, De Preter V et al. The influence of inulin on the absorption of nitrogen and the production of metabolites of protein fermentation in the colon. Br J Nutr 2006; 96: 1078-1086
76. De Preter V, Vanhoutte T, Huys G et al. Baseline microbiota activity and initial bifidobacteria counts influence responses to prebiotic dosing in healthy subjects. Aliment Pharmacol Ther 2008; 27: 504-513
77. De Preter V, Geboes K, Verbrugghe K et al. The in vivo use of the stable isotope-labelled biomarkers lactose-[15N]ureide and [2H4]tyrosine to assess the effects of pro- and prebiotics on the intestinal flora of healthy human volunteers. Br J Nutr 2004; 92: 439-446
78. De Preter V, Vanhoutte T, Huys G et al. Effects of Lactobacillus casei Shirota, Bifidobacterium breve, and oligofructoseenriched inulin on colonic nitrogen-protein metabolism in healthy humans. Am J Physiol Gastrointest Liver Physiol 2007; 292: G358-G368
79. Meijers BK, De Preter V, Verbeke K et al. p-Cresyl sulfate serum concentrations in haemodialysis patients are reduced by the prebiotic oligofructose-enriched inulin. Nephrol Dial Transplant 2010; 25: 219-224
80. Cloetens L, Broekaert WF, Delaedt Y et al. Tolerance of arabinoxylan- oligosaccharides and their prebiotic activity in healthy subjects: A randomised, placebo-controlled crossover study. Br J Nutr 2010; 103: 703-713
81. Rampton DS, Cohen SL, Crammond VD et al. Treatment of chronic renal failure with dietary fiber. Clin Nephrol 1984; 21: 159-163
82. 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
83. Younes H, Egret N, Hadj-Abdelkader M et al. Fermentable carbohydrate supplementation alters nitrogen excretion in chronic renal failure. J Ren Nutr 2006; 16: 67-74
84. Miranda Alatriste PV, Urbina AR, Gomez Espinosa CO et al. Effect of probiotics on human blood urea levels in patients with chronic renal failure. Nutr Hosp 2014; 29: 582-590
85. Ranganathan N, Ranganathan P, Friedman EA et al. Pilot study of probiotic dietary supplementation for promoting healthy kidney function in patients with chronic kidney disease. Adv Ther 2010; 27: 634-647
86. Hida M, Aiba Y, Sawamura S et al. Inhibition of the accumulation of uremic toxins in the blood and their precursors in the feces after oral administration of Lebenin, a lactic acid bacteria preparation, to uremic patients undergoing hemodialysis. Nephron 1996; 74: 349-355
87. Takayama F, Taki K, Niwa T. Bifidobacterium in gastroresistant seamless capsule reduces serum levels of indoxyl sulfate in patients on hemodialysis. Am J Kidney Dis 2003; 41: S142-S145
88. Taki K, Takayama F, Niwa T. Beneficial effects of Bifidobacteria in a gastroresistant seamless capsule on hyperhomocysteinemia in hemodialysis patients. J Ren Nutr 2005; 15: 77-80
89. Ando Y, Miyata Y, Tanba K et al. Effect of oral intake of an enteric capsule preparation containing Bifidobacterium longum on the progression of chronic renal failure. Nihon Jinzo Gakkai Shi 2003; 45: 759-764
90. Natarajan R, Pechenyak B, Vyas U et al. Randomized controlled trial of strain-specific probiotic formulation (renadyl) in dialysis patients. Biomed Res Int 2014; 2014: 568571
91. Hoppe B, Dittlich K, Fehrenbach H et al. Reduction of plasma oxalate levels by oral application of Oxalobacter formigenes in 2 patients with infantile oxalosis. Am J Kidney Dis 2011; 58: 453-455
92. Campieri C, Campieri M, Bertuzzi V et al. Reduction of oxaluria after an oral course of lactic acid bacteria at high concentration. Kidney Int 2001; 60: 1097-1105
93. Lieske JC, Goldfarb DS, De Simone C et al. Use of a probiotic to decrease enteric hyperoxaluria. Kidney Int 2005; 68: 1244-1249
94. Ferraz RR, Marques NC, Froeder L et al. Effects of Lactobacillus casei and Bifidobacterium breve on urinary oxalate excretion in nephrolithiasis patients. Urol Res 2009; 37: 95-100
95. Goldfarb DS, Modersitzki F, Asplin JR. A randomized, controlled trial of lactic acid bacteria for idiopathic hyperoxaluria. Clin J Am Soc Nephrol 2007; 2: 745-749
96. Nakabayashi I, Nakamura M, Kawakami K et al. Effects of synbiotic treatment on serum level of p-cresol in haemodialysis patients: A Preliminary Study. Nephrol Dial Transplant 2011; 26: 1094-1098
97. Guida B, Germano R, Trio R et al. Effect of short-term synbiotic treatment on plasma p-cresol levels in patients with chronic renal failure: A randomized clinical trial. Nutr Metab Cardiovasc Dis 2014; 24: 1043-1049
98. Pavan M. Influence of prebiotic and probiotic supplementation on the progression of chronic kidney disease. Minerva Urol Nefrol 2014; in press
99. Lieske JC, Regnier C, Dillon JJ. Use of sevelamer hydrochloride as an oxalate binder. J Urol 2008; 179: 1407-1410
100. Brandenburg VM, Schlieper G, Heussen N et al. Serological cardiovascular and mortality risk predictors in dialysis patients receiving sevelamer: A prospective study. Nephrol Dial Transplant 2010; 25: 2672-2679
101. Schulman G, Agarwal R, Acharya M et al. A multicenter, randomized, double-blind, placebo-controlled, dose-ranging study of AST-120 (Kremezin) in patients with moderate to severe CKD. Am J Kidney Dis 2006; 47: 565-577
102. Akizawa T, Asano Y, Morita S et al. Effect of a carbonaceous oral adsorbent on the progression of CKD: A multicenter, randomized, controlled trial. Am J Kidney Dis 2009; 54: 459-467
103. Konishi K, Nakano S, Tsuda S et al. AST-120 (Kremezin) initiated in early stage chronic kidney disease stunts the progression of renal dysfunction in type 2 diabetic subjects. Diabetes Res Clin Pract 2008; 81: 310-315
104. Shoji T, Wada A, Inoue K et al. Prospective randomized study evaluating the efficacy of the spherical adsorptive carbon AST-120 in chronic kidney disease patients with moderate decrease in renal function. Nephron Clin Pract 2007; 105: C99-107
105. Schulman G, Berl T, Beck GJ et al. Randomized placebocontrolled EPPIC trials of AST-120 in CKD. J Am Soc Nephrol 2014; doi: 10.1681/ASN 2014010042
106. Wu IW, Hsu KH, Sun CY et al. Oral adsorbent AST-120 potentiates the effect of erythropoietin-stimulating agents on Stage 5 chronic kidney disease patients: A Randomized Crossover Study. Nephrol Dial Transplant 2014; 29: 1719-1727
107. Anraku M, Tanaka M, Hiraga A et al. Effects of chitosan on oxidative stress and related factors in hemodialysis patients. Carbohydr Polym 2014; 112: 152-157
108. Evenepoel P, Bammens B, Verbeke K et al. Acarbose treatment lowers generation and serum concentrations of the protein-bound solute p-cresol: A Pilot Study. Kidney Int 2006; 70: 192-198
109. Cummings JH, Hill MJ, Bone ES et al. The effect of meat protein and dietary fiber on colonic function and metabolism. II. Bacterial metabolites in feces and urine. Am J Clin Nutr 1979; 32: 2094-2101
110. Gibson G, Scott K, Rastall R. Dietary Prebitoics: Current status and new defintion. IFRS Functional FoodsBulletin 2010; 7: 1-19
111. Koppe L, Pillon NJ, Vella RE et al. p-Cresyl sulfate promotes insulin resistance associated with CKD. J Am Soc Nephrol 2013; 24: 88-99
112. Furuse SU, Ohse T, Jo-Watanabe A et al. Galactooligosaccharides attenuate renal injury with microbiota modification. Physiol Rep 2014; 2. doi: 10.14814/phy 2.12029
113. 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; 33: 633-646
114. Sanders ME. Probiotics: Definition, sources, selection, and uses. Clin Infect Dis 2008; 46(Suppl 2): S58-S61
115. Mandal A, Mandal S, Roy S et al. Assessment of efficacy of a potential probiotic strain and its antiuremic and antoxidative activities. e-SPEN J 2013; 8: E155-e163
116. Mandal A, Das K, Roy S et al. In vivo assessment of bacteriotherapy on acetaminophen-induced uremic rats. J Nephrol 2013; 26: 228-236
117. Ranganathan N, Patel BG, Ranganathan P et al. In vitro and in vivo assessment of intraintestinal bacteriotherapy in chronic kidney disease. ASAIO J 2006; 52: 70-79
118. Ranganathan N, Patel B, Ranganathan P et al. Probiotic amelioration of azotemia in 5/6th nephrectomized Sprague- Dawley rats. Scientific World J 2005; 5: 652-660
119. Jankowski J, Westhof T, Vaziri ND et al. Gases as uremic toxins: Is there something in the air? Semin Nephrol 2014; 34: 135-150
120. Rossi M, Johnson DW, Morrison M et al. SYNbiotics easing renal failure by improving Gut microbiologY (SYNERGY): A protocol of placebo-controlled randomised cross-over trial. BMC Nephrol 2014; 15: 106
121. Barna MM, Kapoian T, O'Mara NB. Sevelamer carbonate. Ann Pharmacother 2010; 44: 127-134
122. Kays MB, Overholser BR, Mueller BA et al. Effects of sevelamer hydrochloride and calcium acetate on the oral bioavailability of ciprofloxacin. Am J Kidney Dis 2003; 42: 1253-1259
123. Phan O, Ivanovski O, Nguyen-Khoa Tet al. Sevelamer prevents uremia-enhanced atherosclerosis progression in apolipoprotein E-deficient mice. Circulation 2005; 112: 2875-2882
124. Kikuchi K, Itoh Y, Tateoka R et al. Metabolomic search for uremic toxins as indicators of the effect of an oral sorbent AST-120 by liquid chromatography/tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878: 2997-3002
125. Schulman G, Vanholder R, Niwa T. AST-120 for the management of progression of chronic kidney disease. Int J Nephrol Renovasc Dis 2014; 7: 49-56
126. Ueda H, Shibahara N, Takagi S et al. AST-120, an oral adsorbent, delays the initiation of dialysis in patients with chronic kidney diseases. Ther Apher Dial 2007; 11: 189-195
127. Lekawanvijit S, Kumfu S,Wang BH et al. The uremic toxin adsorbent AST-120 abrogates cardiorenal injury following myocardial infarction. PLoS One 2013; 8: E83687
128. Saito H, Yoshimura M, Saigo C et al. Hepatic sulfotransferase as a nephropreventing target by suppression of the uremic toxin indoxyl sulfate accumulation in ischemic acute kidney injury. Toxicol Sci 2014; 141: 206-217
129. Vanholder R, De Smet R, Waterloos MA et al. Mechanisms of uremic inhibition of phagocyte reactive species production: Characterization of the role of p-cresol. Kidney Int 1995; 47: 510-517
130. Saigo C, Nomura Y, Yamamoto Y et al. Meclofenamate elicits a nephropreventing effect in a rat model of ischemic acute kidney injury by suppressing indoxyl sulfate production and restoring renal organic anion transporters. Drug Des Devel Ther 2014; 8: 1073-1082
131. Levey AS, Adler S, Caggiula AW et al. Effects of dietary protein restriction on the progression of advanced renal disease in the Modification of Diet in Renal Disease Study. Am J Kidney Dis 1996; 27: 652-663