Moderate Renal Impairment and Toxic Metabolites Produced by the Intestinal Microbiome: Dietary Implications Michael Pignanelli, BMSc, Chrysi Bogiatzi,

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Moderate Renal Impairment and Toxic Metabolites Produced by the Intestinal Microbiome: Dietary Implications Michael Pignanelli, BMSc, Chrysi Bogiatzi, MD, Gregory Gloor, PhD, Emma Allen-Vercoe, PhD, Gregor Reid, PhD, Bradley L. Urquhart, PhD, Kelsey N. Ruetz, BMSc, Thomas J. Velenosi, PhD, J. David Spence, MD Journal of Renal Nutrition Volume 29, Issue 1, Pages 55-64 (January 2019) DOI: 10.1053/j.jrn.2018.05.007 Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 Plasma levels of GDUT by quartile of eGFR. Boxplots show plasma levels of GDUT in μmol/L by quartile of eGFR (calculated using the CKD-EPI equations). eGFR quartiles: Q1, <66 mL/min per 1.73 m2; Q2, 66-78; Q3, 79-90; Q4, ≥ 91). (A) TMAO; (B) P-cresyl sulfate; (C) hippuric acid; (D) indoxyl sulfate; (E) P-cresyl glucuronide; (F) phenylacetyl glutamine; (G) phenyl sulfate. Plasma levels of all the metabolites were significantly higher in lower quartiles of eGFR; P values were computed for differences in median values by the Kruskal-Wallis test because the distribution of plasma levels was not normally distributed. CKD, chronic kidney disease; GDUT, gut-derived uremic toxins; TMAO, trimethylamine n-oxide. Journal of Renal Nutrition 2019 29, 55-64DOI: (10.1053/j.jrn.2018.05.007) Copyright © 2018 National Kidney Foundation, Inc. Terms and Conditions