CKD伴IDA患者予乳铁蛋白联合益生元的研究进展

Research Progress of Lactoferrin Combined with Galactooligosaccharide in Patients with Chronic Kidney Disease and Iron-deficiency Anemia

缺铁性贫血(IDA)是慢性肾病(CKD)的常见并发症,CKD还可导致肠道微生物组成的变化和屏障功能的破坏。常规以及新型口服铁补充剂如磷酸盐结合剂柠檬酸铁可能会对缺铁性CKD患者的肠道微生物组和胃肠道功能产生不利影响,从而加重肾功能和贫血。天然形式的铁如乳铁蛋白可能是替代现有口服铁补充剂的良好候选物。由于口服铁给药可以减少有益的乳杆菌科和双歧杆菌科的数量,因此口服铁给药期间提供益生元可以潜在协同作用。其减少微生物尿毒症毒素产生并抵消铁诱导的有益物种减少,一起有助于减少炎症。总之,乳铁蛋白和益生元低聚半乳糖的共同治疗,能够在补充铁的同时,减少铁对肠道菌群的负面影响。

Iron deficiency anemia(IDA)is a common complication of chronic kidney disease(CKD).CKD can also cause changes in the composition of the intestinal microbe and the destruction of barrier function.Conventional and new oral iron supplements such as the phosphate binder ferric citrate may adversely affect the gut microbiome and gastrointestinal function of patients with iron-deficiency CKD,which aggravate renal function and anemia.Natural forms of iron such as lactoferrin may be good candidates to replace existing oral iron supplements.Since oral iron administration can reduce the number of beneficial Lactobacillus and Bifidobacteriaceae,the provision of prebiotics during oral iron administration can potentially have a synergistic effect.It could reduce the production of microbial uremic toxins and counteract the reduction of iron-induced beneficial species,which may reduce inflammation.All in all,the co-treatment of lactoferrin and prebiotic galactooligosaccharides may be able to supplement iron while reducing the negative impact of iron on the intestinal flora.