Layman’s summary: Research indicates that there are opportunities to improve dialysis through longer dialysis regimes and low-protein diets.
Publication date: December 2013
Published in: American Journal of Nephrology
Lead author: Nosratola D. Vaziri- Emeritus Professor of Medicine
University of California Irvine
Former Chief, Division of Nephrology and Hypertension and former Chairman of Department of Medicine, Medicine School of Medicine

Abstract: Chronic kidney disease (CKD) impairs intestinal barrier function which leads to endotoxemia and systemic inflammation. We have found depletion of intestinal epithelial tight junction (TJ) proteins in animals with CKD. We further showed that addition of end-stage renal disease patients’ plasma to the culture medium provokes a marked drop in transepithelial electrical resistance (TER) and depletion of TJ proteins in cultured human enterocytes. These effects were less severe with post- than with prehemodialysis plasma, suggesting a role of dialyzable agent(s). This study tested the hypothesis that intestinal barrier dysfunction in uremia may be due to diffusion of urea into the gut and its conversion to ammonia by microbial urease.

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