Document Detail


Bowel bacterial overgrowth as another cause of malnutrition, inflammation, and atherosclerosis syndrome in peritoneal dialysis patients.
MedLine Citation:
PMID:  21348395     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Bowel bacterial overgrowth syndrome (BBOS) is an important cause of gastrointestinal (GI) abnormalities. Proinflammatory cytokines (PICs) are excessively produced and accumulate because of kidney failure in dialysis patients who experience chronic infections such as BBOS. We explored the association between GL function, BBOS, and the malnutrition, inflammation, and atherosclerosis (MIA) syndrome. We studied GI malabsorption and maldigestion by analyzing fecal starch, sugar, fat, and nitrogen; intestinal protein permeability (alpha1-antitrypsin fecal clearance); and fecal chymotrypsin. We evaluated BBOS by breath hydrogen test (BHT) after a 3-day fat-and-carbohydrate-overload diet. Positive BHT was present in 10 patients, showing a high prevalence of GI macronutrient malabsorption and maldigestion, and compared with the other patients, the highest plasma levels of tumor necrosis factor alpha and interleukin 6 and lower levels of albumin and prealbumin. Those 10 patients were treated with a combination of several antibiotics, including neomycin, amoxicillin-clavulanate, and quinolones. Between 2 and 3 months later, the BHT, markers of nutrition, and PIC were re-tested. All treated patients showed an improvement in nutrition status and a lesser inflammatory pattern. The BBOS infectious process is found frequently in dialysis patients in association with GI malabsorption and maldigestion, malnutrition, and systemic inflammation. Hyperproduction of PIC because of BBOS induces MIA through a double pathway: GI disorders and deleterious systemic effects.
Authors:
Abelardo Aguilera; Liliana Gonzalez-Espinoza; Rosa Codoceo; Maria del Carmen Jara; Mario Pavone; Maria Auxiliadora Bajo; Gloria Del Peso; Olga Celadilla; Maria Victoria Martínez; Manuel López-Cabrera; Rafael Selgas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in peritoneal dialysis. Conference on Peritoneal Dialysis     Volume:  26     ISSN:  1197-8554     ISO Abbreviation:  Adv Perit Dial     Publication Date:  2010  
Date Detail:
Created Date:  2011-02-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104803     Medline TA:  Adv Perit Dial     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  130-6     Citation Subset:  IM    
Affiliation:
Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, Spain. aguileraa@terra.es
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