The following is the summary of “Correlation between serum trimethylamine-N-oxide concentration and protein-energy wasting in patients on maintenance hemodialysis,” published in the October 2022 issue of Renal failure by  Hu, et al.

Protein and energy loss are 2 of the many systemic alterations linked to chronic kidney disease (CKD), aa major health issue (PEW). The precise mechanism of PEW in CKD is still unknown. Trimethylamine-N-oxide (TMAO) is a uremic toxin and significant intestinal flora metabolite that has been linked to an increased risk of death in people with chronic kidney disease (CKD), particularly those who require maintenance hemodialysis (MHD). However, research on this idea still needs to be done.

In a sample of CKD patients using MHD, PEW was identified using the criteria established by the International Society of Renal Nutrition and Metabolism. High-performance liquid chromatography-mass spectrometry was used to determine the TMAO levels in the serum. After controlling for demographics, co-morbidities, and laboratory results, researchers used linear regression and logistic analysis to examine whether or not there was an association between TMAO levels and PEW. A significantly greater concentration of TMAO was found in the blood of MHD patients than in those of control (healthy) persons (5653.76 ± 2853.51 ng/mL vs. 254.92 ± 1978.8 ng/mL, P<0.001). 

When the MHD patients were tested for PEW, those with PEW had considerably higher serum TMAO levels than those without PEW (6,760.9 vs. 4,016.1 ng/mL, P<0.001). Furthermore, a strong inverse association existed between body mass index (BMI), dietary protein intake, and serum TMAO levels. After controlling for potential confounders, the serum TMAO concentration was still substantially linked with PEW occurrence in the logistic regression analysis. In individuals with MHD, PEW is substantially linked with the circulating TMAO level. PEW is a common complication of CKD, and TMAO may be a therapeutic target for preventing and treating PEW in CKD, especially in ESRD.

Source: tandfonline.com/doi/full/10.1080/0886022X.2022.2131572