High circulating trimethylamine-N-oxide (TMAO) is associated with an increased risk of cardiovascular disease and mortality in people with chronic kidney disease (CKD). In individuals with CKD, reduced kidney function leads to decreased excretion of TMAO, which results in accumulation in the circulation. Higher circulating TMAO has been linked to higher intake of animal-based foods in omnivorous diets. Thus, plant-based diets have been suggested as an intervention to slow the progression of CKD and reduce cardiovascular risk, perhaps explained in part by reduced TMAO production. This article reviews the current evidence on plant-based diets as a dietary intervention to decrease gut-derived TMAO production in patients with CKD, while highlighting methodological issues that present challenges to advancing research and subsequent translation of this approach. Overall, we find that plant-based diets are promising for reducing gut-derived TMAO production in patients with CKD but that further interventional studies are warranted.
Bibliographical noteFunding Information:
Support: This work was partially supported by NIH grants K01 DK102864 (KMHG), K23 DK102824 (RNM), T32 AR065971 (AB), R01 DK11087103 and UL1 TR002529 (SMM) and Veterans Affairs grant I01 BX001471 (SMM).Financial Disclosure: A.B. reports honoraria from Amgen.
© 2020 National Kidney Foundation, Inc.
PubMed: MeSH publication types
- Research Support, U.S. Gov't, Non-P.H.S.
- Journal Article
- Research Support, N.I.H., Extramural