Author:Leo and Lucy
Keywords: chronic kidney disease
 |
| From google images |
There is no doubt that the intestine is also the main organ of uremic toxins produced and excreted. The gut has a mechanical barrier, a mucous barrier, an immune barrier, and a biological barrier that maintains the steady state of the intestine and the entire environment. Among them, the biological barrier is mainly parasitic in the intestine surface of a large number of bacteria, viruses, protozoa and fungi and other components.
There is no doubt that the intestine is also the main organ of uremic toxins produced and excreted.
The gut has a mechanical barrier, a mucous barrier, an immune barrier, and a biological barrier that maintains the steady state of the intestine and the entire environment. Among them, the biological barrier is mainly parasitic in the intestine surface of a large number of bacteria, viruses, protozoa and fungi and other components.
Under normal circumstances, the intestinal micro-ecosystem and the body in a dynamic balance, once the balance is destroyed, it may cause damage to the entire intestinal barrier function, resulting in the number of bacteria, the proportion of change or cause spatial transfer, which led to Endogenous infection.
Animal experiments confirmed that uremia can lead to intestinal barrier damage, and then cause intestinal bacterial translocation. Intestinal flora translocation refers to the presence of active intestinal flora through the intestinal barrier to the mesenteric lymph nodes and other organs or sites outside the intestine, currently extending to the release of bacterial release products (such as endotoxin and bacterial DNA).
As early as a few centuries ago, people tried to use intestinal lavage to treat renal failure, colonic dialysis therapy still in use today. In addition, people have developed the use of some intestinal adsorbents to increase the removal of uremic toxins. In recent years, as people understand the intestinal flora more in-depth, has been involved in the study of chronic kidney disease. These studies suggest that by reconstructing the steady state of intestinal flora can reduce the level of uremic toxins in this population to a certain extent.
The maintenance of steady state of intestinal flora is also closely related to the metabolism of intestinal ammonia.
Ammonia is a metabolite of urea decomposition of urea, is one of uremic toxins, its concentration is too high on the intestinal tract and other organs of the body are damaged. Because chronic renal failure in patients with long-term capacity overload, resulting in gastrointestinal edema, gastrointestinal motility weakened, and then cause intestinal microflora microbial imbalance, especially urease-containing bacteria overgrowth, leading to intestinal Ammonia increases.
While the edema of the gastrointestinal tract of dietary protein absorption capacity will decline, will lead to more protein in the large intestine by the role of spoil bacteria to form ammonia. Studies have shown that probiotics can be used to restore uremia in patients with intestinal microflora steady state, thereby effectively reducing the level of uremic toxins in the body, and can improve the quality of life of patients.
Intestinal flora disorders are closely related to the development of chronic kidney disease, and the treatment concept based on the steady state of intestinal flora is likely to contribute to the rehabilitation of patients with chronic kidney disease.
Intestine is the main place where uremic toxins are produced and absorbed. Some of these toxins (AGE, phenols, indoles) have a strong biological effect. Dietary protein from the tyrosine and phenylalanine from the intestinal plant flora to its metabolism, first metabolized into 4 phenolic acid, and then decarboxylated to p-cresol, in its through the intestinal mucosa, the cytosol In the conversion of p-cresol to p-cresol sulfate.
They are associated with progression of chronic kidney disease, cardiovascular disease and bone metabolic disorders. They belong to the protein binding material, it is difficult to be hemodialysis and filtration cleared. Studies have shown that consumption of fructose-rich inulin can reduce the blood of patients with hemodialysis in the blood of p-cresol sulfate concentration. In addition, the study found that compared with the healthy population, IgA nephropathy in the number of fecal bacteria in the control group was significantly reduced, such as Bacteroides, Lactobacillus, Bifidobacterium, etc., and the number of harmful bacteria increased, such as E. Line bacteria and so on.
At present, the treatment strategy for intestinal flora and related toxins has the following aspects:
① by giving prebiotics and probiotics or adjust the diet to regulate the composition of intestinal flora species and proportion;
② through drug absorption, combined with intestinal bacteria metabolic substances, or affect the rate of intestinal peristalsis emptying, thereby reducing the intestinal absorption of uremic toxins.
Prebiotics is a food that is not digested by the body, it is in the intestine as a source of energy for the flora, can be targeted to promote the growth of some beneficial bacteria. Prebiotics include inulin, galactooligosaccharides, oligofructose, xylo-oligosaccharides, coke dextrin and the like.
They can promote the proliferation of beneficial bacteria, adjust the intestinal flora structure, thereby reducing the formation of intestinal bacteria. Probiotics are a kind of living bacteria that contribute to human health, including Bifidobacterium, lactic acid bacteria, streptococcus and so on. Probiotics can help to supplement the beneficial bacteria in patients with CKD deficiency, inhibit the excessive proliferation of harmful bacteria, reduce chronic Inflammation and reduce the synthesis of uremic toxins.
Email:kdtinchina@yahoo.com
whatsapp:008615931093124
