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Open Access 15-09-2022 | Glomerulonephritis | Original Article

Intestinal permeability in patients with IgA nephropathy and other glomerular diseases: an observational study

Authors: Claudia Seikrit, Judith I. Schimpf, Stephanie Wied, Eleni Stamellou, Ana Izcue, Oliver Pabst, Thomas Rauen, Kaatje Lenaerts, Jürgen Floege

Published in: Journal of Nephrology | Issue 2/2023

Abstract

Background

A dysregulated ‘gut-kidney axis’ may contribute to immunoglobulin A nephropathy (IgAN). We studied whether IgAN patients have disturbed intestinal permeability.

Methods

In a prospective, cross sectional, pilot study we assessed intestinal permeability in 35 IgAN patients, 18 patients with non-IgAN glomerulonephritides (GNs) and 19 healthy controls. After an overnight fast, trial participants ingested a multi-sugar solution and samples were obtained from 0 to 2, 2 to 5- and 5 to 24-h urine portions. Urinary sugar concentrations were quantified using isocratic ion-exchange high performance liquid chromatography. Indices of small intestinal permeability (0–2-h lactulose/L-rhamnose (L/R) ratio), distal small intestinal and proximal colonic permeability (2–5-h sucralose/erythritol (S/E) ratio) and colonic permeability (5–24-h sucralose/erythritol (S/E) ratio) were evaluated. Associations between groups and indices of intestinal permeability were investigated by a linear mixed model.

Results

Small intestinal permeability (0–2 h L/R-ratio) was significantly increased in patients with glomerular diseases versus healthy controls. More precisely, increased small intestinal permeability was exclusively noted in non-IgAN GN patients, whereas IgAN patients exhibited a trend towards elevated small intestinal permeability. In total, 54% of patients with IgAN and 67% of non-IgAN GN patients had increased small intestinal permeability. Neither distal small intestinal and proximal colonic permeability nor colonic gut permeability indices (i.e., 2–5 h and 5–24 h S/E ratios) were significantly different between controls and any of the GN patient groups.

Conclusion

The present single center pilot study suggests that disturbed intestinal permeability is common in patients with glomerular diseases and is not specific for IgAN.

Trial registration number

German Clinical Trials Register DRKS00021533, Date: 24.04.2020.

Graphical abstract

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Title: Intestinal permeability in patients with IgA nephropathy and other glomerular diseases: an observational study
Authors: Claudia Seikrit
Judith I. Schimpf
Stephanie Wied
Eleni Stamellou
Ana Izcue
Oliver Pabst
Thomas Rauen
Kaatje Lenaerts
Jürgen Floege
Publication date: 15-09-2022
Publisher: Springer International Publishing
Keywords: Glomerulonephritis
Chronic Kidney Disease
Published in: Journal of Nephrology / Issue 2/2023
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-022-01454-2

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Abstract

Background

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Results

Conclusion

Trial registration number

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