Abstract

Abstract Background and Aims Increased gut permeability and intestinal dysbiosis may contribute to chronic inflammation, leading to accelerated atherosclerosis and cardiovascular complications in patients on haemodialysis (HD). Constipation is highly prevalent in HD patients and growing evidence suggested constipation can aggravate gut microbiota dysbiosis and gut inflammation. The aim of this study was to evaluate the association between markers of microbial translocation, intestinal permeability and inflammation in HD patients with and without constipation. Method A cross-sectional, observational study was conducted and 200 stable prevalent HD were enrolled. Serum zonulin, eotaxin-1, amyloid A, intestinal fatty acid-binding protein (iFABP), IL-6, endotoxin core antibodies (EndoCAb) and lipopolysaccharide binding protein (LBP) levels were measured. Functional constipation was defined according to the Rome IV criteria. Results Serum levels of zonulin and eotaxin-1 but not LPS, endo-Cab IgG, amyloid A and IL-6 were significantly higher in HD patients with constipation than in non-constipated HD controls. The multiple logistic regression analysis in constipated HD patients after adjustment for age, and BMI demonstrated that serum zonulin and eotaxin-1 were independently associated with constipation with an odds ratio (OR) of 1.24 (95% CI = 1.09-1.42, p = 0.0016) and 1.02 (95% CI = 1.01-1.03, p = 0.0001), respectively. Conclusion We demonstrate that there was association between serum eotaxin-1 and zonulin levels in constipated HD patients. This may indicates that increased intestinal inflammation or intestinal permeability in these patients but the significance of these findings need further investigation.

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