Changes in gut microbial ecology are common in chronic kidney disease (CKD) and may contribute to CKD progression. Dietary approaches to favorably altering the composition of gut microbial communities as treatment for CKD have been the focus of recent studies. Resistant starch is a prebiotic that promotes proliferation of gut bacteria and increases the production of metabolites such as short-chain fatty acids; numerous health-promoting benefits have been seen with supplementation of resistant starch.
However, according to Matthew Snelson, PhD, and colleagues, the mechanism of how these metabolites positively influence renal health is unclear. Recent evidence has demonstrated that microbiota-derived metabolites can regulate the incretin axis and mitigate inflammation via expansion of regulatory T cells. Results of studies in animals and patients with CKD have shown that concentrations of uremic retention solutes, including indoxyl sulfate and p-cresyl sulfate, are attenuated with supplementation of resistant starch.
The researchers examine the efficacy of resistant starch in animal models and humans with CKD and explore ways supplementation of resistant starch might be a promising dietary approach for slowing progression of CKD.