Acute haemodynamic changes during haemodialysis do not exacerbate gut hyperpermeability.

Area of Science:

• Nephrology
• Gastroenterology
• Clinical Investigation

Background:

• Uremia may compromise the gut barrier, increasing intestinal permeability.
• Hemodialysis might worsen gut barrier dysfunction due to mesenteric ischemia from volume shifts.

Purpose of the Study:

• To investigate the acute effect of hemodialysis on intestinal permeability.
• To compare intestinal permeability between hemodialysis patients and healthy controls.

Main Methods:

• Ten hemodialysis patients and five controls orally ingested a solution of four sugar probes (lactulose, rhamnose, sucralose, erythritol).
• Plasma levels of sugars were measured for 10 hours.
• Intestinal permeability was assessed twice in patients: on a non-dialysis day and immediately after hemodialysis.

Main Results:

• No significant acute changes in intestinal permeability were observed immediately after hemodialysis compared to non-dialysis days.
• Hemodialysis patients had higher plasma levels and slower clearance of lactulose, sucralose, and erythritol compared to controls, attributed to impaired kidney function.
• The lactulose:rhamnose ratio was higher in hemodialysis patients versus controls, but the sucralose:erythritol ratio showed no significant difference.

Conclusions:

• The hemodialysis procedure itself did not acutely alter intestinal permeability.
• Comparing intestinal permeability between hemodialysis patients and controls is challenging due to the confounding effect of renal function on sugar probe levels.