Tuesday, January 11, 2011

Probiotics and uremia (益生菌和尿毒症)

Hi,

Uremia is one unwanted complication that may happen in patients of endstage renal diseases (ESRD). For the past several decades, different approaches have been adopted to tackle it. A few are based on the use of enzymes or bacteria to remove the toxic metabolic wastes. Recently, an enteric coated capsule containing live bacterial cells has been indicated to have good result for a limited number of predialysis kidney patients (stage 3 and 4). Its veterinary version has received some positive feedback from owners of felines or canines suffering from kidney failure.

It is also important to point out that in the use of probiotics, formulation is important to its success. Enteric version of delayed-release to allow optimal bacterial action in colon may work well as gut-based alternate kidney if the bacterial species selected are sensitive to habitat such as pH environment (gastric pH 1 versus intestinal pH 7). Also, dosing of culture in colony-forming unit (cfu) may also be relevant (billion cfu vs million cfu). Furthermore, an appropriate selection of bacteria can be crucial to the success of probiotics. As a result, any OTC probiotics for colon comfort or gas relief may not always be suitable for kidney patients in relieving symptoms of uremia. It may also be good to choose a symbiotics (i.e. a probiotics that also contains a prebiotics which can be some sort of fiber serving as nutrient for the probiotic bacteria). For probiotics to work, bowel movement is important. So, it would be better if we can check with our doctors before taking any probiotics and make sure we have an elimination mechanism for toxic waste.

Ref:
http://www.kibowbiotech.com/pdfs/Probiotic%20Amelioration%20of%20Azotemia%20in%205-6th%20Nephrectomized%20Sprague%20Dawley%20Rats.pdf

L-arginine / L-citrulline in Blood Pressure Control

Hi,

In my earlier posting of agents for blood pressure (BP) control, I have referenced some papers on the use of L-arginine / L-citrulline for potential roles in BP reduction. Would like to emphasize that the use of these dietary supplements should be carefully discussed with healthcare providers and monitored. Both compounds act as precursors to facilitate nitric oxide production which may leads to endothelial dilation of blood vessels, thus lowering BP. However, they may also produce the tissue-damaging NO radical that is disadvantageous. Also, they may produce more nitrogenous waste products such as urea in the nitrogen cycle. It is hard to predict which way the two agents will act in our body upon consumption. That may be highly dependent on our physiological condition and health status. So, I would like to point this out here. There is always a risk of taking in agents of unclear mechanisms.


Tuesday, December 21, 2010

藥物配方 - 營養補充劑-腎Formulation and Drug Bioavailability-Kidney

藥物配方 - 營養補充劑 - 腎 Formulation and Drug Bioavailability

Please always check with your healthcare providers before taking on any dietary supplements. Also, try to do it under medical supervision. Our body condition may influence the absorption and elimination of various substances. So, please watch out for dosing and drug interactions.

Hi,

Drug fornulation is important in the pharmaceutical product development. When we read scientific publications, we have to pay attention at the dosage and form of the pharmaceutical forms. Immediate-release (IR) formulation can have very different bioavailability from those of controlled-release (CR)/ extended-release (ER) / timed-release or even delayed release (DR). So, please do not substitute one product for another if they are not tested of equivalent bioavailability and bioequivalency.  Also, please do not split tablets that are used for CR/ER/TR/DR. They are supposed to take in whole form for their various target drug release profiles.

Another thing is about excipients (inactive ingredients) that are present in formulations. Sometimes, they may interfere with the absorption of main active ingredients.  For example, a paper suggests the presence of vitamin E in Coenzyme Q10 may be less beneficial than expected. So, we may better look at product label more carefully when shopping for our products. More may not be merrier.

-J.

Ref:

控制磷,- 腎 (Phosphorus and kidney dialysis)

Please always check with your healthcare providers before taking on any dietary supplements. Also, try to do it under medical supervision. Our body condition may influence the absorption and elimination of various substances. So, please watch out for dosing and drug interactions.

Hi,

I am told that phosphorus control is important for hemodialysis patients. If the phosphorus level is too high, skin itching and other side-effects will kick in. Calcium supplements and non-calcium phosphorus binders (such as Renagel - sevelamer is used). The latter can be costly.

Here are some links to a cheaper dietary supplement proposed as an alternate phosphorus binder. Again, these are preliminary studies and they do not mean to substitute for your prescription. We should always discuss any medication and dietary supplement with our medical professional. Also, formulation differences may have important effect on safety, toxicity and efficacy profiles.

In this case, the new alternative (niacin) can have side effect of flushing. It is advised to take a low dose of aspirin to reduce flushing. However, aspirin can interfere with some drugs like anti-clotting drugs of warfarin. It may be contraindicted in some cases.   Secondly, the use of immediate-release and extended-release drug formulation should be carefully investigated for.

-J.

Ref:


控制血壓,- 腎 (Blood pressure control and kidney dialysis)

Hi,

  I have copied some links to some articles that suggest some use of non-drug supplements for blood pressure control. Pls be aware that the publications are based on limited experimental studies and may not apply for human consumptions.

Please always check with your healthcare providers before taking on any dietary supplements. Also, try to do it under medical supervision. Our body condition may influence the absorption and elimination of various substances. So, please watch out for dosing and drug interactions.

 Pls feel free to let me know what you think of these.

-Jamie.



Purpose of this blog - Blog的目的

Hi,

   I am a science major and am working in the biotech sector. I create this blog to share some info on the use of dietary supplement, esp for kidney dialysis patients. I have known people on dialysis that need help to control their blood pressure and other electrolyte levels.

   Hopefully the info with the scientific publication can help.

-- Jamie 


Disclaimer:

Please note:
1. Do consult your health care providers before taking any dietary supplements.
2. Information provided is only for reference. Please do review them carefully to apply to your case.
3. All dietary supplements mentioned are not meant to be replaced by medications. They are not intended to diagnose, treat, cure or prevent any disease.
4. All statements and products in this website are not evaluated by FDA.
-----


Blog的目的

我在生物科技區工作。 我創造這個網上日誌是希望能分享營養補充劑和腎臟透析病人的認識.我認識的人有需要幫助控制他們的血压和其他電解質水平。

希望這個blog內的科學文章信息能對您有幫助。

 - Jamie

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