Kidney Disease, Chronic Clinical Trial
Official title:
Efficacy of Pea Hull Fiber Supplementation on Gastrointestinal Transit Time-induced Reduction in Proteolytic Fermentation and Enhancement of Wellness in Individuals With Lifestyle-related Chronic Disease and Overweight. (Phase 3)
The purpose of this study is to determine the effects of daily consumption of snacks with and without pea hull fiber on gastrointestinal function, gastrointestinal symptoms, food intake, appetite, changes in fecal and microbial composition and activity. Fifty maintenance hemodialysis hemodialysis and CKD patients in stage 4 or 5 will be recruited to participate in a randomized, blinded, 13-week cross-over study evaluating snack foods containing 15 g/d of pea hull fiber.
Maintenance hemodialysis hemodialysis and CKD patients in stage 4 or 5 (n=50) will be
recruited for the study. A randomized, controlled, double-blind, cross-over study will be
carried out. Following a 1-week baseline, participants will be assigned to receive snacks
with pea hull fiber or control followed by a 4-week wash-out period, and then crossed over to
the second intervention. Snacks with added pea hull fiber (15 g/d) and control will be
provided to participants in identical packaging. Participants will collect 4 days of stools
during the baseline week, week 5, 9, and 13 and analyzed for mineral content. Microbiota
composition will be analyzed including microbial diversity, qPCR to quantify changes and 16S
rRNA sequencing to identify pea hull fiber effects on specific bacteria. Following baseline,
participants will attend a second visit and anthropometric and demographic information will
be collected and we will measure blood pressure, the body composition by bioelectrical
impedance analysis (BIA), and handgrip strength using a dynamometer.
Throughout the study, participants must complete a daily questionnaire to evaluate the
transit time (eg. Bristol Stool Scale), stool frequency, and compliance. Every week,
questionnaires to evaluate appetite (eg. SNAQ) and GI wellness (eg. GSRS - Gastrointestinal
Symptom Response Scale) will be administered. During each study visit, participants will
complete a questionnaire to evaluate the quality of life. In addition, the dietary data
(24-hour diet recalls) will be collected by phone during the baseline week and during the
last week of each period. During baseline, treatment and each washout, fasting blood will be
collected and analyzed for a comprehensive metabolic panel with eGFR, in addition to
microbial metabolites (e.g., indoxyl sulfate and p-cresyl sulfate), and inflammatory markers
(e.g. CRP, TNFα, IL-6).
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