3 research outputs found
The Dietary Fiber Inulin Slows Progression of Chronic Kidney DiseaseâMineral Bone Disorder (CKDâMBD) in a Rat Model of CKD
Abstract Chronic kidney disease (CKD)âmineral bone disorder (CKDâMBD) leads to fractures and cardiovascular disease. Observational studies suggest beneficial effects of dietary fiber on both bone and cardiovascular outcomes, but the effect of fiber on CKDâMBD is unknown. To determine the effect of fiber on CKDâMBD, we fed the Cy/+ rat with progressive CKD a caseinâbased diet of 0.7% phosphate with 10% inulin (fermentable fiber) or cellulose (nonâfermentable fiber) from 22âweeks to either 30 or 32âweeks of age (~30% andâ~15% of normal kidney function; CKD 4 and 5). We assessed CKDâMBD end points of biochemistry, bone quantity and quality, cardiovascular health, and cecal microbiota and serum gutâderived uremic toxins. Results were analyzed by twoâway analysis of variance (ANOVA) to evaluate the main effects of CKD stage and inulin, and their interaction. The results showed that in CKD animals, inulin did not alter kidney function but reduced the increase from stage 4 to 5 in serum levels of phosphate and parathyroid hormone, but not fibroblast growth factorâ23 (FGF23). Bone turnover and cortical bone parameters were similarly improved but mechanical properties were not altered. Inulin slowed progression of aorta and cardiac calcification, left ventricular mass index, and fibrosis. To understand the mechanism, we assessed intestinal microbiota and found changes in alpha and beta diversity and significant changes in several taxa with inulin, together with a reduction in circulating gut derived uremic toxins such as indoxyl sulfate and shortâchain fatty acids. In conclusion, the addition of the fermentable fiber inulin to the diet of CKD rats led to a slowed progression of CKDâMBD without affecting kidney function, likely mediated by changes in the gut microbiota composition and lowered gutâderived uremic toxins. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research