The intestinal flora appears to have a significant influence on the development of chronic kidney disease. Intestinal bacteria form an organic compound from various nutrients from animal foods, which leads to a faster decline in kidney function.
A new, large-scale study involving experts from the University of Washington examined how intestinal trimethylamine N-oxide (TMAO) influences the risk of chronic kidney disease and overall decline in kidney function. The results are published in the “Journal of the American Society of Nephrology”.
What role does the intestinal flora play?
The team involved in the study has been researching the role of intestinal flora in cardiovascular health and in the development of various diseases for more than a decade.
This includes analyzing the negative effects of trimethylamine N-oxide (TMAO), a byproduct formed by intestinal bacteria from nutrients found in large quantities in red meat, eggs and other animal foods.
To do this, the researchers examined not only the kidney function, but also the TMAO blood values of a total of 10,564 adult participants from two prospective, community-based cohorts.
TMAO increases the risk
During an average follow-up period of 9.4 years, it was shown that participants with an increased TMAO level had a significantly higher risk of developing chronic kidney disease in the future, the experts report.
The team also found that higher levels of TMAO were associated with an overall faster decline in kidney function in both people with normal kidney function and those with impaired kidney function at baseline.
Even after taking into account known risk factors for kidney disease, sociodemographic characteristics, lifestyle habits and diet, the relationships found remained, the researchers report.
Promotes tissue fibrosis
The results of the current study are consistent with previous preclinical model studies that have shown that TMAO directly promotes both the deterioration of kidney function and tissue fibrosis, the experts add.
“The results indicate a remarkably strong clinical association between increased TMAO and an increased risk of developing chronic kidney disease,” emphasizes study author Stanley Hazen in a recent press release.
Given the diversity of the participants, the results are certainly generalizable, according to the doctor.
Many suffer from chronic kidney disease
Chronic kidney disease is a known strong risk factor for cardiovascular disease and, according to experts, affects around ten to 15 percent of people worldwide, indicating a major public health burden.
The new results make it clear that TMAO levels are as strong, if not stronger, an indicator of chronic kidney disease risk than already known risk factors such as diabetes and high blood pressure, the research team said.
This suggests that lowering TMAO levels with medication could be an effective treatment for people at increased risk of kidney disease or with early signs of kidney disease.
TMAO can be influenced by diet
In general, the TMAO level can be strongly influenced not only by pharmacological interventions, but also by diet, the researchers report.
Therefore, in addition to the use of new medications, nutritional measures to reduce TMAO levels could represent a cost-effective and at the same time low-risk prevention strategy against the development of chronic kidney disease, summarizes the study author Dr. Meng Wang. (as)