[Progress in therapy for testicular tumors]

Beneficial Effect of Dietary Fiber on Hyperuricemia in Rats and Humans: A Review

Hyperuricemia is recognized as a lifestyle-related disease and the prevalence is increasing in many parts of the world. Excessive intake of purines increases serum uric acid concentration and is thought to be one factor causative of hyperuricemia. Therefore, it is thought that prevention of hyperuricemia by dietary control may be very important. This is an article of our basic research regarding the role of dietary fiber in the suppression of hyperuricemia induced by dietary purines in rats; in addition, clinical research suggesting the possibility that dietary fiber intake has a beneficial effect on the prevention or suppression of hyperuricemia in humans is discussed. Our own studies reveal that the test dietary fiber significantly suppresses the elevation of serum uric acid concentration induced by dietary RNA (12.3-46.2%), adenosine-5'-monophosphate (9.5-23.2%), adenosine (10.7-20.4%), or adenine (16.3-38.9%) and suppresses experimental hyperuricemia in rats. The mechanism is presumed to be mediated by suppression of the digestion and/or absorption of dietary purines by dietary fiber. In clinical studies, intake of dietary fiber decreases serum uric acid concentrations. Reports of recent epidemiological studies indicate that higher levels of hyperuricemia increase the prevalence of its comorbidities (e.g., chronic kidney disease, obesity, hypertension, diabetes, and cardiovascular disease) and dietary fiber intake is associated with significantly lower risk for hyperuricemia and its comorbidities. We wish to emphasize the importance of recognizing the validity of increased dietary fiber intake as a preventive or suppressive method for hyperuricemia and its comorbidities.

Six-year dialysis freedom in end-stage renal disease

BACKGROUND

Patients with end-stage renal disease (ESRD) cannot sustain life in the absence of renal replacement therapy (RRT). However, a 4-year dialysis freedom with improved well-being has been reported in ESRD using a new therapeutic approach combining conservative measures and acacia gum (AG) supplementation. The aim of this paper is to report the achievement of 6-year dialysis freedom.

PATIENTS AND METHODS

During December 2001, six patients with ESRD and significant uremia that required at least one dialysis session to maintain life were enrolled in a clinical trial investigating the use of a new therapeutic approach combining conservative measures and AG supplementation aiming at improving well-being and providing patients with ESRD dialysis freedom. Three patients were treated with this approach. One patient complied with protocol for only 10 days and died after 6 months peritoneal dialysis. Two patients completed 1 year on this therapeutic regimen. Both patients reported improved well-being. Neither became acidotic nor uremic, and neither required dialysis during the 1 year of the study period. Both patients maintained serum creatinine and urea levels not previously achieved without dialysis. The other three patients were managed with intermittent peritoneal dialysis (IPD). All died within less than 6 months. Of the two surviving patients on AG supplementation, one patient stopped AG supplementation after 1 year and died within 1 month despite IPD. The other patient continued to be treated with this novel approach and continued to experience improved well-being and dialysis freedom. The aim of this paper is to report the achievement of 6-year dialysis freedom in this patient.

RESULTS

During 6 years of therapy the girl continued in experiencing improved well-being and good participation in outdoor activities. Mild uremic symptoms occurred only during periods of noncompliance. Periods of decreased compliance with pharmacologic therapies were associated with anemia and renal osteodystrophy and some degree genue vulgum has resulted.

CONCLUSION

It was possible to address ESRD in this particular patient as a disease process that can be treated by totally different medical treatment approaches without the use of either chronic dialysis or transplant.