EFFECTS OF SULFORAPHANE SUPPLEMENTATION ON PLASMA LEVELS OF UREMIC TOXINS IN PATIENTS UNDERGOING HEMODIALYSIS

Patients with chronic kidney disease (CKD) present intestinal dysbiosis, which is associated with increased production of uremic toxins, such as indoxyl sulfate (IS), p-cresyl sulfate (p-CS), and indole-3-acetic acid (IAA). Nutritional strategies such as bioactive compounds may modulate intestinal microbiota composition, reducing these metabolites. Sulforaphane (SFN) is a bioactive compound found in cruciferous vegetables (Brassicaceae family); however, no study has evaluated its effect on uremic toxins. Thus, this study aimed to evaluate the effects of SFN on plasma levels of uremic toxins in CKD patients on hemodialysis (HD).

This is a double-blind crossover randomized clinical trial with a washout period performed with patients undergoing HD allocated into the SFN group (1 sachet/day, containing 1% sulforaphane extract (2.5 g) or placebo group (1 sachet/day, containing, corn starch colored with chlorophyll), for two months each intervention period. Blood collection, food intake, and anthropometric assessment were carried out at the beginning and end of the study. Uremic toxins, such as IS, pCS, and IAA, originating from the intestinal microbiota were assessed by HPLC.

30 patients started the study, and 14 patients were allocated to the SFN group (40% female; 57.5 (14) years; 60 (46) months HD vintage, BMI 26.4 (11.3) kg/m² and 1.5 (0.3) Kt/V) and 16 in the placebo group (26.7% female; 55 (20) years; 44 (83) months HD vintage, BMI 26.8 (6.7) kg/m² and 1.4 (0.2) Kt/V) (Table 1). However, only 25 patients finished the crossover design.  The uremic toxins plasma levels were increased in the patients compared to the EUtox reference. However, the SFN supplementation could not decrease plasma levels of these toxins (Figure 1).

Conclusions