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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
Abstract
The plasma levels of phenol, p-cresol, and indican are markedly increased in uremic patients, and cannot be efficiently reduced by hemodialysis. Such uremic toxins, which are produced in the intestine as bacterial putrefactive metabolites, accumulate to a great degree in the feces of hemodialysis patients. Oral administration of Lebenin®, a preparation consisting of antibiotic-resistant lactic acid bacteria, reduced the levels of fecal putrefactive metabolites to levels comparable with those of healthy subjects. Moreover, the plasma level of indican also significantly decreased in these Lebenin-treated patients. An analysis of the fecal microflora revealed that a disturbed composition of the microflora characterized by an overgrowth of aerobic bacteria is restored to normal by oral administration of Lebenin in hemodialysis patients. These results thus demonstate that oral administration of lactic acid bacteria in uremic patients is effective in reducing the levels of uremic toxins, especially that of indican, in the blood by inhibiting bacterial production by means of correcting the intestinal microflora.
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“Such beneficial effects of Lactobacillus could be the result of effects of this bacteria on the permeability and immune status of the gut epithelium.”
From The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease (2018) · cites this paper as [218]
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Review on uremic toxins: Classification, concentration, and interindividual variability
Vanholder, R. C., For the European Uremic Toxin Work Group (EUTox), Smet, R. D., Glorieux, G., Argilés, À., Baurmeister, U., Brunet, P., Clark, W. R., Cohen, G., Deyn, P. P. D., et al. (2003) · Kidney International · doi:10.1046/j.1523-1755.2003.00924.x · Cited by 1,716
Normal and Pathologic Concentrations of Uremic Toxins
Duranton, F., Cohen, G., Smet, R. D., Rodríguez, M., Jankowski, J., Vanholder, R. C., & Argilés, À. (2012) · Journal of the American Society of Nephrology · doi:10.1681/asn.2011121175 · Cited by 965
The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease
Yang, T., Richards, E. M., Pepine, C. J., & Raizada, M. K. (2018) · Nature Reviews Nephrology · doi:10.1038/s41581-018-0018-2 · Cited by 753
The Gut Microbiome, Kidney Disease, and Targeted Interventions
Ramezani, A., & Raj, D. S. (2013) · Journal of the American Society of Nephrology · doi:10.1681/asn.2013080905 · Cited by 773
The uremic solutes p-cresol and indoxyl sulfate inhibit endothelial proliferation and wound repair
Dou, L., Bertrand, E., Cérini, C., Faure, V., Sampol, J., Vanholder, R., Berland, Y., & Brunet, P. (2004) · Kidney International · doi:10.1111/j.1523-1755.2004.00399.x · Cited by 494
Metadata
- Authors
- Hida, M., Aiba, Y., Sawamura, S., Suzuki, N., Satoh, T., & Koga, Y.
- Affiliations
- Tokai University (JP)
- Wakamoto Pharmaceutical (Japan) (JP)
- Kidney Centre (PK)
- ORCID
- Koga, Yasuhiro
- Venue
- Nephron
- Publisher
- S. Karger AG
- Published
- 2008-12-24
- Volume
- 74
- Issue
- 2
- Pages
- 349-355
- ISSN
- 1660-8151 (ISSN-L)
- 2235-3186
- OpenAlex
- W2075674899
- Cited by
- 295
- References
- 0
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 9 · 2023: 15 · 2022: 19 · 2021: 14 · 2020: 20 · 2019: 21 · 2018: 24 · 2017: 18 · 2016: 16 · 2015: 21 · 2014: 12 · 2013: 15 · 2012: 5
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Nephron journals/Nephron journals (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Keywords
- lactic acid bacteria, uremic toxins, hemodialysis, indican, p-cresol, phenols, gut microbiota, oral administration, uremic patients
- MeSH terms
- Administration, Oral, Adult, Bacteria, Aerobic, Bacteria, Anaerobic, Bifidobacterium, Capsules, Cresols, Feces, Female, Renal Dialysis, Humans, Indican, Lactobacillus acidophilus, Male, Middle Aged, Phenols, Enterococcus faecalis, Uremia, Phenol
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