Gut microbial-dependent trimethylamine-N-oxide (TMAO) pathway contributes to both development of renal insufficiency and mortality risk in chronic kidney disease.

High serum concentrations of TMAO are associated with high incidence of renal disorders and mortality.

Dietary choline, lecithin (phosphatidylcholine), and L-carnitine are rich sources of trimethylamine-N-oxide (TMAO). This research work was carried out to determine the relationship between plasma levels of TMAO and renal disease development, progression, and mortality risks. Researchers measured the fasting serum concentrations of TMAO in 521 chronic kidney disease (CKD) patients and healthy subjects. The renal and total mortality hazard risks of the subjects were also assessed.

Researchers discovered that the CKD patients had higher blood levels of TMAO than the healthy subjects. A high prevalence of renal disorders, such as renal tubulointerstitial fibrosis, was found in subjects with high plasma levels of TMAO. The findings of this study show that a greater risk of renal morbidity and mortality is associated with high consumption of choline-, lecithin, and L-carnitine-rich foods.

 

Research Summary Information

  • 2015
  • Tang WH, Wang Z, Kennedy DJ, Wu Y, Buffa JA, Agatisa-Boyle B, Li XS, Levison BS, Hazen SL.
  • From the Department for Cellular and Molecular Medicine, Lerner Research Institute (W.H.W.T., Z.W., D.J.K., J.A.B., B.A.-B., X.S.L., B.S.L., S.L.H.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, OH (W.H.W.T., S.L.H.); and Department of Mathematics, Cleveland State University, OH (Y.W.). tangw@ccf.org hazens@ccf.org. From the Department for Cellular and Molecular Medicine, Lerner Research Institute (W.H.W.T., Z.W., D.J.K., J.A.B., B.A.-B., X.S.L., B.S.L., S.L.H.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, OH (W.H.W.T., S.L.H.); and Department of Mathematics, Cleveland State University, OH (Y.W.).
  • Yes, Free full text of study was found:
  • Source of funding disclosure found
  • This research was supported by grants from the National Institutes of Health and the Office of Dietary Supplements (R01HL103866, P20HL113452). The GeneBank study has been supported by NIH grants P01HL076491, P01HL098055, R01HL103931, and the Cleveland Clinic Clinical Research Unit of the Case Western Reserve University CTSA (UL1TR 000439). Dr. Wang was partially supported by an American Heart Association Scientist Development Grant 12SDG12050473. Dr. Kennedy was partially supported by an American Heart Association Scientist Development Grant 14SDG18650010. Dr. Hazen is also partially supported by a gift from the Leonard Krieger endowment. Mass spectrometry studies were performed on instruments housed in a facility supported in part by a Center of Innovations Award by AB SCIEX.
  • Potential conflicts disclosure found
  • Drs.Wang, Levison and Hazen are named as co-inventor on pending patents held by the Cleveland Clinic relating to cardiovascular diagnostics and/or therapeutics. Dr. Hazen reports having been paid as a consultant for the following companies: Cleveland Heart Lab, Esperion, Liposcience Inc., and P&G. Dr. Hazen reports receiving research funds from Cleveland Heart Lab, Liposcience Inc., P&G and Takeda. Drs. Wang, Levison and Hazen report having the right to receive royalty payments for inventions or discoveries related to cardiovascular diagnostics and/or therapeutics from Cleveland Heart Lab, and Dr. Hazen also from the companies shown below: Siemens, Esperion, Frantz Biomarkers, LLC. All other authors have no relationships to disclose.
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