Abstract:
Chronic kidney disease (CKD) patients suffer from the accumulation of toxic substances in their blood due to the loss of kidney function, which results in hyperphosphatemia. This condition contributes to hyperparathyroidism, leading to the development of chronic kidney disease-related mineral bone disorder (CKD-MBD). Additionally, CKD patients experience changes in their gut microbiota, disrupting epithelial tight junctions and allowing excessive absorption of dietary phosphate. In this study, we aimed to investigate the effects of various oligosaccharides and probiotics on the gut microbiota, intestinal barrier, hyperphosphatemia, and hyperparathyroidism in CKD rats. We isolated Lactobacillus and Bifidobacterium strains from healthy participants and tested their ability to enhance transepithelial electrical resistance and reduce inflammation in Caco-2 cells, to determine their suitability as probiotics. Moreover, we evaluated the impact of oligosaccharides, including chitosan oligosaccharide (COS), inulin, and maltodextrin, on Caco-2 cells in terms of non-toxic concentration, enhancement of transepithelial electrical resistance, and expression of tight junction genes.
Subsequently, all the selected oligosaccharides and probiotics were administered to CKD rats induced by intraperitoneal injection of cisplatin. Following 12 weeks of oral treatment with a combination of COS, inulin, Lactobacillus salivarius LBR2-28, and Bifidobacterium longum BFS3-09, we observed a slight alteration in gut microbiota diversity and an increase in the relative abundance of beneficial bacteria in the rat intestine. Furthermore, this treatment promoted intestinal barrier function and led to a reduction in hyperphosphatemia and hyperparathyroidism, although no significant change in bone density was observed. Our findings indicate that this treatment approach has the potential to ameliorate hyperparathyroidism in CKD-MBD, highlighting its therapeutic implications in managing the associated complications.
