A new discovery by Cleveland Clinic and Tufts University researchers shows that high blood levels of TMAO (trimethylamine N-oxide) predict future risk of developing chronic kidney disease over time. I am.

This discovery follows more than a decade of research led by Stanley Hazen, MD, and his team related to the role of the gut microbiome in cardiovascular health and disease, including the negative effects of TMAO, a byproduct formed by the gut. It is based on. Bacteria from nutrients abundant in red meat, eggs, and other animal foods.

This study Journal of the American Society of Nephrology, The study was a collaboration between the Cleveland Clinic research team led by Dr. Hazen and researchers at the Food is Medicine Institute at Tufts University’s Friedman School of Nutrition Science and Policy, including first author Dr. Meng Wang and co-senior professors. Ta. Author Darish Mozaffarian, MD, PH.

This large-scale study measured blood levels of TMAO over time in two large National Institutes of Health populations and averaged renal function in more than 10,000 U.S. adults with normal kidney function at baseline. Followed over a 10-year follow-up period. Researchers found that participants with elevated TMAO blood levels were at increased risk of developing chronic kidney disease in the future.

Higher TMAO levels were also associated with a faster rate of kidney function decline in people with normal or compromised kidney function at baseline. These associations were independent of sociodemographic characteristics, lifestyle, diet, and other known risk factors for kidney disease. This finding is also consistent with previously reported preclinical model studies showing that TMAO directly promotes both renal function decline and tissue fibrosis.

“The results of this study demonstrate a significant and strong clinical association between elevated TMAO and an increased risk of developing chronic kidney disease,” said Dr. said Dr. Hazen, co-chair of the Department of Prevention. Department of Cardiology, Cardiovascular Thoracic Institute. “The results were obtained from individuals from diverse ethnic and sociodemographic backgrounds who initially had normal renal function. The diversity of participants ensures that the results are generalizable. It helps.”

Chronic kidney disease is a major public health challenge in the United States and globally, affecting approximately 10-15% of the world’s population. It is also a strong risk factor for cardiovascular disease. This study showed that TMAO levels are as good an indicator of chronic kidney disease risk as, or better than, known risk factors such as diabetes, hypertension, age, and race.

The study results add to a growing body of evidence that lowering TMAO with prescription drugs can be an effective treatment for patients at risk for, or with early signs of, kidney disease. be.

“Our study is an important complement to research in preclinical models supporting TMAO as a novel biological risk factor for chronic kidney disease,” said Dr. Wang, a research assistant professor in the Friedman School. “TMAO levels are highly modifiable by both lifestyle-aligned diet and pharmacological interventions. In addition to using new drugs to lower TMAO in patients, diet to lower TMAO in the general population Using interventions may represent a cost-effective, low-risk prevention strategy against the development of chronic kidney disease.”

Future research plans include testing genetic data to help evaluate potential causal relationships between TMAO and chronic kidney disease, and whether lifestyle changes may prevent the onset and progression of chronic kidney disease. It includes a more clear study of the

Dr. Hazen directs the Center for Microbiome and Human Health at the Cleveland Clinic and holds the Jan Bleeksma Chair in Vascular Cell Biology and Atherosclerosis.

This research was supported by grants from the National Institutes of Health and the American Heart Association Postdoctoral Fellowship.

Dr. Hazen has been named as a co-inventor on pending and issued patents held by Cleveland Clinic related to cardiovascular diagnosis and treatment, and has been named as a co-inventor on pending and issued patents held by Cleveland Clinic related to cardiovascular diagnosis and treatment. is entitled to receive royalty payments.