The Colonic Transit Time: a Modifiable Determinant of Intestinal Production and Uptake of Microbial Metabolites?
Status:
Withdrawn
Trial end date:
2018-12-01
Target enrollment:
Participant gender:
Summary
Chronic kidney disease is associated with the accumulation of various metabolites, i.e.,
uremic retention solutes. Evidence is mounting that the colonic microbiome contributes
substantially to these uremic retention solutes. Indoxyl sulfate and p-cresyl sulfate are
among the most extensively studied gut microbial metabolites, and are associated with
cardiovascular disease, chronic kidney disease progression and overall mortality. Colonic
transit time is an important determinant of intestinal generation and uptake of bacterial
metabolites. However, it is unknown if accelerating the colonic transit time reduces the
intestinal generation and uptake of indoxyl sulfate and p-cresyl sulfate. Prucalopride is a
selective, high-affinity 5-HT4 receptor agonist with a stimulating effect on colonic motility
and transit. It is currently used in treating chronic slow-transit constipation. An
observational study will be initiated in non-chronic kidney disease patients with chronic
slow-transit constipation necessitating treatment with prucalopride to observe its effect on
serum concentrations and intestinal generation of indoxyl sulfate and p-cresyl sulfate.