{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:15:49Z","timestamp":1793085349472,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T00:00:00Z","timestamp":1529625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hospital do Rim \u2013 Funda\u00e7\u00e3o Oswaldo Ramos"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microbial-derived uremic toxins, p-cresyl sulfate (PCS), indoxyl sulfate (IS) and indole 3-acetic acid (IAA), have been associated with the burden of chronic kidney disease (CKD). Prebiotics have emerged as an alternative to modulate the gut environment and to attenuate toxin production. This trial aims to investigate the effect of a prebiotic fructooligosaccharide (FOS) on uremic toxins of non-dialysis-dependent CKD (NDD-CKD) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A double-blind, placebo-controlled, randomized trial was conducted for 3\u2009months. In all, 50 nondiabetic NDD-CKD patients [estimated glomerular filtration rate (eGFR)\u2009&amp;lt;45\u2009mL\/min\/1.73\u2009m2], aged 18\u201380\u2009years, were allocated to prebiotic (FOS, 12\u2009g\/day) or placebo (maltodextrin, 12\u2009g\/day) groups. Primary outcomes were changes in serum (total and free) and urinary (total) PCS. Secondary outcomes included changes in IS, IAA, serum markers of intestinal permeability (zonulin), gut-trophic factors (epidermal growth factor and glucagon-like peptide-2), eGFR, inflammation (high sensitive c-reactive protein and interleukin-6), homeostatic model assessment-insulin resistance, lipid profile and gastrointestinal symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 50 participants (54% men, 57.3\u2009\u00b1\u200914.6\u2009years and eGFR\u200921.4\u2009\u00b1\u20097.6\u2009mL\/min\/1.73\u2009m2), 46 completed the follow-up. No changes in dietary intake or gastrointestinal symptoms were observed. There was a trend in the difference of serum total \u0394PCS (treatment effect adjusted for baseline levels: \u221212.4\u2009mg\/L; 95% confidence interval (\u22125.6 to 0.9\u2009mg\/L; P\u2009=\u20090.07) and serum-free \u0394%PCS [intervention \u22128.6 (\u221241.5 to 13.9%) versus placebo 3.5 (\u221228.8 to 85.5%); P\u2009=\u20090.07] between the groups. The trend in the difference of serum total \u0394PCS was independent of eGFR and dietary protein:fiber ratio intake. No difference was found in urinary PCS. Aside from the decreased high-density lipoprotein cholesterol in the intervention, no differences were observed in the change of IS, IAA or other secondary outcome between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our result suggests the potential of FOS in reducing serum total and free PCS in nondiabetic NDD-CKD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ndt\/gfy171","type":"journal-article","created":{"date-parts":[[2018,5,14]],"date-time":"2018-05-14T15:10:21Z","timestamp":1526310621000},"page":"1876-1884","source":"Crossref","is-referenced-by-count":90,"title":["Effect of prebiotic (fructooligosaccharide) on uremic toxins of chronic kidney disease patients: a randomized controlled trial"],"prefix":"10.1093","volume":"34","author":[{"given":"Christiane Ishikawa","family":"Ramos","sequence":"first","affiliation":[{"name":"Nutrition Program, Universidade Federal de S\u00e3o Paulo (UNIFESP) , S\u00e3o Paulo, Brazil"},{"name":"Hospital do Rim \u2013 Funda\u00e7\u00e3o Oswaldo Ramos , S\u00e3o Paulo, Brazil"},{"name":"Faculty of Health Sciences and Medicine, Bond University , Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel Gatti","family":"Armani","sequence":"additional","affiliation":[{"name":"Hospital do Rim \u2013 Funda\u00e7\u00e3o Oswaldo Ramos , S\u00e3o Paulo, Brazil"},{"name":"Division of Nephrology, UNIFESP , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eugenia Fernandes","family":"Canziani","sequence":"additional","affiliation":[{"name":"Hospital do Rim \u2013 Funda\u00e7\u00e3o Oswaldo Ramos , S\u00e3o Paulo, Brazil"},{"name":"Division of Nephrology, UNIFESP , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Aparecida","family":"Dalboni","sequence":"additional","affiliation":[{"name":"Division of Nephrology, UNIFESP , S\u00e3o Paulo, Brazil"},{"name":"Post-graduate Program in Medicine, Universidade Nove de Julho (UNINOVE) , S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla Juliana Ribeiro","family":"Dolenga","sequence":"additional","affiliation":[{"name":"Department of Basic Pathology, Universidade Federal do Paran\u00e1 (UFPR) , Curitiba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia Sumie","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Basic Pathology, Universidade Federal do Paran\u00e1 (UFPR) , Curitiba, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina Louise","family":"Campbell","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine, Bond 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