Intestinal transport of organic food compounds and drugs: A scoping review on the alterations observed in chronic kidney disease

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2024-11-02 DOI:10.1016/j.clnesp.2024.10.166

Mara Lauriola , Ward Zadora , Ricard Farré , Björn Meijers

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引用次数: 0

Abstract

Background and aims

Around 850 million people worldwide are affected by chronic kidney disease (CKD). Patients with CKD often develop malnutrition and sarcopenia and changes in the pharmacokinetics of drugs. A reduced kidney function partially explains the prolonged half-life of certain drugs due to decreased renal clearance, which leads to an increased risk of adverse effects. While the intestine plays a fundamental role in this context, a systematic review of the effects of CKD on intestinal transport is lacking. We aimed to systematically summarize all the available evidence on intestinal transport of organic food components (carbohydrates/sugar, proteins/amino acids, fats, vitamins) and drugs (including drug transporters) in CKD.

Methods

We conducted a systematic search of all the articles published until the 1st of April 2024, on five databases i.e. Embase, PubMed, Web of Science Core Collection, Cochrane Library, and Scopus. This systematic review was registered on the Open Science Framework (OSF) (osf.io/5e6wb) and was carried out according to the PRISMA 2020 guidelines.

Results

From 9205 articles identified, 68 met the inclusion criteria. Absorption of organic food compounds seems to be altered, in general, and reduced for vitamins. The expression of intestinal efflux drug transporters may be altered in CKD.

Conclusions

Despite alterations in intestinal transport is suggested to be altered in CKD, the lack of recent studies, the paucity of human data and the heterogeneity of the methodologies used underscore the need for more research on the effect of CKD and uremia on intestinal transport.

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有机食物化合物和药物的肠道转运：关于慢性肾病中观察到的变化的范围综述。

背景和目的：全球约有 8.5 亿人受到慢性肾脏病（CKD）的影响。慢性肾脏病患者通常会出现营养不良和肌肉疏松，药物的药代动力学也会发生变化。肾功能减退可部分解释某些药物因肾脏清除率降低而导致半衰期延长，从而导致不良反应风险增加。虽然肠道在其中扮演着重要角色，但目前还缺乏关于慢性肾功能衰竭对肠道转运影响的系统性综述。我们旨在系统总结慢性肾脏病患者肠道转运有机食物成分（碳水化合物/糖、蛋白质/氨基酸、脂肪、维生素）和药物（包括药物转运体）的所有现有证据：我们在 Embase、PubMed、Web of Science Core Collection、Cochrane Library 和 Scopus 等五个数据库中对 2024 年 4 月 1 日前发表的所有文章进行了系统检索。该系统性综述在开放科学框架（OSF）（osf.io/5e6wb）上注册，并按照PRISMA 2020指南进行：结果：在已确定的 9205 篇文章中，有 68 篇符合纳入标准。总体而言，有机食物化合物的吸收似乎发生了改变，而维生素的吸收则有所减少。CKD患者肠道外流药物转运体的表达可能会发生改变：尽管有人认为 CKD 会改变肠道转运功能，但近期研究的缺乏、人体数据的贫乏以及所使用方法的不一致性，都凸显出有必要就 CKD 和尿毒症对肠道转运功能的影响开展更多研究。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.