- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04768309
Impact of Intestinal Microbiota on Uremic Toxins Productions (GUTCOL)
September 26, 2023 updated by: Hospices Civils de Lyon
Assessment of the Production of Uremic Toxins by the Gut Microbiota of Patients With Chronic Kidney Disease: in Vitro Test
Chronic renal failure (CKD) affects 3 million people in France and is characterized by the accumulation of uremic toxins (UTs) such as p-cresyl sulfate (PCS) and indoxyl sulfate (IS) which participate in cardiovascular complications and disturbance of the carbohydrate metabolism associated with CKD.
These UTs are not eliminated by dialysis due to their high affinity for albumin and alternative strategies to dialysis must be developed to decrease the production of TUs in patients not yet in dialysis.
The dysregulation of the intestinal microbiota observed during CKD increases the generation of UTs in the intestine, by the transformation of amino acids derived from proteins (such as tyrosine and tryptophan transformed respectively into PCS and, IS).
Thus, modulation of the intestinal microbiota seems to be an attractive target for reducing the production of UTs and the comorbidities associated with CKD.
Some studies have demonstrated the potential interest of probiotics in lowering the plasma concentration of UTs, but the effects remain unclear.
In order to test the interest of probiotics during CKD, the investigators have, in collaboration with the Nestlé laboratory and the ProDigest platform, the possibility of testing probiotics using a human intestine simulator before the investigation of experimental and human models.
For this the investigators would need a collection of fresh stools.
The fresh stools will be instilled in artificial intestine to test the efficacy of selected probiotics on UTs production.
Study Overview
Status
Completed
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
20
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Rhône
-
Pierre-Bénite, Rhône, France, 69310
- Lyon Sud University Hospital
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Age between 18 and 80 years old
- Non diabetic (fasting blood glucose <1.26 g / L, or lack of insulin or oral antidiabetic treatment)
- BMI between 18 and 30 kg / m²
- Patient with CKD stage 4-5 ( eDFG < 30 ml/min/1.73m2 CKD-EPI)
- Not dialyzed
- No history of kidney transplant
- Patient followed in the nephrology department of Pr FOUQUE at the Lyon Sud hospital center
Exclusion Criteria:
- Active inflammatory, infectious, cardiovascular or neoplastic disease
- Colectomy, resection of the small intestine or cholecystectomy
- Patient having received antibiotics, prebiotics, probiotics in the last 3 months.
- Patient using laxatives (more than 2 doses per day for the last 3 months)
- Known renal pathology or known urologic malformation (healthy volunteer only)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: CKD group
CKD adult patients stage 4-5 Without diabetes BMI between 18 and 30 kg/m2
|
Fresh feces in chronic kidney patients and healthy volunteers will be collected.
The feces will be instilled in artificial intestine with and without selected probiotics and production of uremic toxins will be measured.
|
Other: Healthy volunteers group
Adult without chronic treatment, without renal dysfunction
|
Fresh feces in chronic kidney patients and healthy volunteers will be collected.
The feces will be instilled in artificial intestine with and without selected probiotics and production of uremic toxins will be measured.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Production of precursor of one of major uremic toxins: indole
Time Frame: Indoles production will be measured 48 hours after instillation of fresh feces in the artificial intestine
|
The main endpoint is the concentration of the precursor of indoxyl sulfate (indole) in the lumen of the artificial intestine with a microbiota of a patient with CKD compared to the concentration of indol in the lumen of artificial intestine with a microbiota from a patient with CKD and supplemented with a probiotic (supplied by Nestlé)
|
Indoles production will be measured 48 hours after instillation of fresh feces in the artificial intestine
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Uremic toxins production
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
Concentration of various uremic toxins in a human intestine simulator (p-cresyl sulfate, p-cresol, indole-3-acetic acid, etc.).
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Production of short-chain fatty acids (SCFA)
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
Concentration of short-chain fatty acids (SCFA) (acetate, propionate, butyrate, isobutyrate, isovalerate and isocaproate) human intestine simulator
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Intestinal permeability in a human intestine simulator
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
It will be measured by the electrical transepithelial resistance of the intestinal cells.
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Biochemical parameters
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
Concentration of ammonium and lactate in a human intestine simulator.
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Biochemical parameters
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
pH levels of the human intestine simulator.
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Biochemical parameters
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
Volume of gas production in a human intestine simulator.
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Intestinal microbiota composition
Time Frame: 48 hours after instillation of fresh feces in the human intestine simulator
|
Study of the composition of the intestinal microbiota by 16s analysis
|
48 hours after instillation of fresh feces in the human intestine simulator
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
June 4, 2021
Primary Completion (Actual)
July 13, 2021
Study Completion (Actual)
July 13, 2021
Study Registration Dates
First Submitted
February 12, 2021
First Submitted That Met QC Criteria
February 22, 2021
First Posted (Actual)
February 24, 2021
Study Record Updates
Last Update Posted (Actual)
September 28, 2023
Last Update Submitted That Met QC Criteria
September 26, 2023
Last Verified
September 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 69HCL20_1078
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on CKD
-
California Institute of Renal ResearchRecruitingCKD Stage 4 | CKD Stage 5 | CKD Stage 3United States
-
McGill University Health Centre/Research Institute...RecruitingESRD | CKD Stage 4 | CKD Stage 5Canada
-
Assiut UniversityNot yet recruiting
-
NYU Langone HealthNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Recruiting
-
Medical Components, Inc dba MedCompSyneos Health; Veeva SystemsWithdrawnESRD | CKDSpain, United States
-
Sohag UniversityRecruiting
-
University of Illinois at ChicagoAbbottCompleted
-
Fan Fan HouUnknown
Clinical Trials on Ex vivo exploration of the effect of a probiotic over precursor indole production
-
Imcyse SATerminatedMultiple Sclerosis, Relapsing-RemittingBelgium
-
University of California, Los AngelesRecruitingAdenosine Deaminase Severe Combined Immune DeficiencyUnited States
-
University of CopenhagenBispebjerg HospitalNot yet recruitingObesity | Non-Alcoholic Fatty Liver DiseaseDenmark
-
Cari Health Inc.Samplimy Medical ABRecruitingPain, Chronic | Metabolism Medication Toxicity | Methadone Toxicity | Methadone Overdose | Drug Metabolism, Poor, CYP2D6-RelatedUnited States