Prebiotics Improved the Defecation Status via Changes in the Microbiota and Short-chain Fatty Acids in Hemodialysis Patients

摘要

Hemodialysis patients often become constipated. We analyzed the effect of prebiotics on the defecationstatus due to the intestinal environment in hemodialysis patients. Fifteen patients received prebiotics aspartially hydrolyzed guar gum for four weeks. The defecation status was assessed using both the BristolStool Form Scale and the Japanese version of the Constipation Assessment Scale. The fecal status,microbiota measured by a terminal restriction fragment length polymorphism analysis, and fecal shortchain fatty acid concentrations by gas chromatography were compared before and after prebiotics ingestion.Prebiotics ingestion improved the individual stool form and decreased the constipation score from 5.1 to 3.0.The ratio of short-chain fatty acid-producing microbiota, such as Bifidobacterium and Bacteroides,increased after ingestion (2.35- and 3.17-fold, respectively). Furthermore, the concentration of short-chainfatty acids significantly increased (1.58-fold). The individual dendrogram distribution after ingestion waschanged in 8 participants (53.3% of the subjects). In 5 participants (33.3% of the subjects), the clusters wereeven more noticeably different. Prebiotics improved the defecation status in hemodialysis patients due inpart to the composition of intestinal microbiota and short-chain fatty acid concentrations.