High amylose resistant starch diet ameliorates oxidative stress, inflammation, and progression of chronic kidney disease

PLoS One. 2014 Dec 9;9(12):e114881. doi: 10.1371/journal.pone.0114881. eCollection 2014.

Abstract

Inflammation is a major mediator of CKD progression and is partly driven by altered gut microbiome and intestinal barrier disruption, events which are caused by: urea influx in the intestine resulting in dominance of urease-possessing bacteria; disruption of epithelial barrier by urea-derived ammonia leading to endotoxemia and bacterial translocation; and restriction of potassium-rich fruits and vegetables which are common sources of fermentable fiber. Restriction of these foods leads to depletion of bacteria that convert indigestible carbohydrates to short chain fatty acids which are important nutrients for colonocytes and regulatory T lymphocytes. We hypothesized that a high resistant starch diet attenuates CKD progression. Male Sprague Dawley rats were fed a chow containing 0.7% adenine for 2 weeks to induce CKD. Rats were then fed diets supplemented with amylopectin (low-fiber control) or high fermentable fiber (amylose maize resistant starch, HAM-RS2) for 3 weeks. CKD rats consuming low fiber diet exhibited reduced creatinine clearance, interstitial fibrosis, inflammation, tubular damage, activation of NFkB, upregulation of pro-inflammatory, pro-oxidant, and pro-fibrotic molecules; impaired Nrf2 activity, down-regulation of antioxidant enzymes, and disruption of colonic epithelial tight junction. The high resistant starch diet significantly attenuated these abnormalities. Thus high resistant starch diet retards CKD progression and attenuates oxidative stress and inflammation in rats. Future studies are needed to explore the impact of HAM-RS2 in CKD patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Amylose / metabolism*
  • Animals
  • Biomarkers / metabolism
  • Blotting, Western
  • Dietary Fiber / therapeutic use*
  • Disease Progression
  • Inflammation / etiology
  • Inflammation / prevention & control*
  • Male
  • Oxidative Stress*
  • Rats
  • Rats, Sprague-Dawley
  • Reactive Oxygen Species / metabolism
  • Renal Insufficiency, Chronic / complications*
  • Starch / metabolism*

Substances

  • Biomarkers
  • Dietary Fiber
  • Reactive Oxygen Species
  • Starch
  • Amylose

Grant support

This study was supported in part by intramural USDA-ARS Project 5306-51530-019-00 (SHA) and the Danish Council for Strategic Research (RJM). USDA is an equal opportunity provider and employer. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.