Increasing number of studies’ results indicate that intestinal microbiota may be involved in the development and maintenance of hypertensive phenotype in patients with end-stage renal disease. Various metabolites of intestinal bacteria are considered as potential modulators of this association.
OBJECTIVE
To study the relationship between levels of uremic toxins of microbial origin in the blood serum, as well as the content of short-chain fatty acids in faeces and the 24-hour blood pressure profile indicators in patients on long-term hemodialysis.
MATERIALS AND METHODS
Daily blood pressure (BP) monitoring results were analyzed in 80 patients on long-term hemodialysis, clinical laboratory parameters of whom, including the concentration of trimethylamine N-oxide (TMAO), p-cresyl sulfate and indoxyl sulfate in the blood serum, were assessed. A subgroup of 30 patients was examined by gas-liquid chromatography for total fecal content and spectrum of individual short-chain fatty acids (SCFAs). Associations between indicators were studied using the Pearson’s correlation coefficient and multivariate regression analysis.
RESULTS
The dynamics of BP level of the examined patients within 24 hours is characteristic for stable systolic and diastolic arterial hypertension. The daily mean value of pulse pressure (MPP) was also increased. Increased TMAO content (β=0.196; p=0.035) along with concentration of sodium (β=0.265; p=0.006) and C-reactive protein (β=0.225; p=0.03) were independent predictors of MPP increase in the adjusted multidimensional linear regression models. In addition, statistically significant inverse relationship of the mean daily and mean night levels of systolic BP, as well as MPP with total content of SCFAs in faeces, butyric acid level and total concentration of isoacids has been found. However, the found correlations lost their relevance after adjustment for other associated factors in multidimensional regression models.
CONCLUSION
The obtained results provide additional evidence of the important role of intestinal bacteria metabolites in the development of arterial hypertension in patients receiving treatment with hemodialysis.
