Plant-Based Diets, the Gut Microbiota, and Trimethylamine N-Oxide Production in Chronic Kidney Disease: Therapeutic Potential and Methodological Considerations

Gretchen N Wiese, Annabel Biruete, Ranjani N Moorthi, Sharon M Moe, Stephen R Lindemann, Kathleen M Hill Gallant

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
JournalJournal of Renal Nutrition
Early online dateJun 29 2020
DOIs
StateE-pub ahead of print - Jun 29 2020
Externally publishedYes

Bibliographical note

Funding 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.

Publisher Copyright:
© 2020 National Kidney Foundation, Inc.

PubMed: MeSH publication types

  • Review
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Journal Article
  • Research Support, N.I.H., Extramural

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