PARTIALLY HYDROLYZED GUAR GUM INTAKE AMELIORATES CONSTIPATION, IMPROVES NUTRITIONAL STATUS AND REDUCES INDOXYLSULFURIC ACID IN DIALYSIS PATIENTS.

Abstract

Dialysis patients often develop constipation and changes in intestinal bacterial flora. Indoxylsulfuric acid (IS) levels rise as glomerular filtration decreases, and patients with renal failure have high IS. Elevated IS is also caused by increased indole due to altered intestinal flora (Takayama et al, Am J Kidney Dis. 2003). We investigated whether administering partially hydrolyzed guar gum (PHGG) (Sunfiber: a product of Taiyokagaku Co., Ltd., Japan) ameliorates constipation and improves nutritional status in dialysis patients, while decreasing IS levels. Thirty-five patients on maintenance dialysis (mean age, 71 ± 9; male/female= 22/13) ingested PHGG (10 g/day) for 6 weeks. Defecation was scored before and after PHGG intake using a modified Constipation Assessment Scale-Long Term (Japanese version). Nutritional status was rated according to the Geriatric Nutritional Risk Index (GNRI) before and after PHGG intake. IS was measured in 8 patients taking PHGG orally for 24 weeks, for comparison with those in 8 patients not on PHGG. Constipation scores decreased from 7.9 to 5.0 (p 〈.01) and GNRI increased from 95.0 ± 5.0 to 95.9 ± 5.7 (p 〈.05), reflecting amelioration of constipation and improved nutritional status. The ratio of IS after to that before PHGG intake was calculated to analyze the magnitude of IS change. The ratio in patients not on PHGG was 1.2 ± 0.3, i.e. IS rose, while that in patients taking PHGG was significantly reduced (0.8 ± 0.3, p 〈.05). Our results indicate PHGG consumption to ameliorate constipation and improve nutritional status, and that continued intake reduces IS, in dialysis patients.