title: Lactulose for reduction of nitrogen products in patients with chronic kidney disease.
abstract: BACKGROUND
  Patients with chronic kidney disease (CKD) face with uremic toxins. Lactulose could reduce serum urea and creatinine levels and have some effects on lipid profile and bone minerals. The aim of this study was to evaluate effect of lactulose on serum levels of biochemical products in patients with CKD.
  
  
  METHODS
  In this prospective study, 40 patients with stages 3 and 4 of CKD (52.5% men; mean age, 57.5 ± 12.5 years) were evaluated. All patients received lactulose, 30 mL, 3 times per day for 2 months. Blood samples from all participants were collected before and at the end of intervention to examine changes in biochemical parameters, including sodium, potassium, hemoglobin, urea, creatinine, uric acid, leukocyte and platelets count, β2-microglobin, and intact parathyroid hormone.
  
  
  RESULTS
  Lactulose significantly decreased urea levels from 70.35 ± 28.00 mg/dL to 64.50 ± 23.51 mg/dL (P = .04), creatinine levels from 4.04 ± 1.78 mg/dL to 3.45 ± 1.39 mg/dL (P < .001), uric acid levels from 7.31 ± 1.49 mg/dL to 6.71 ± 1.42 mg/dL (P < .001), and β2-microglobin levels from 3.25 ± 0.44 mg/L to 3.08 ± 0.33 mg/L (P = .001). The decrease in serum electrolytes, lipid profile, and intact parathyroid hormone levels were not significant.
  
  
  CONCLUSIONS
  Lactulose administration in CKD patients could decrease levels of various deleterious elements, especially nitrogen products, and its daily use can be recommended in these patients.
authors.forename: Hamid
authors.initials: H
authors.lastname: Tayebi Khosroshahi
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. afshin.habibzadeh@gmail.com.
authors.forename: Afshin
authors.initials: A
authors.lastname: Habibzadeh
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Khoshbaten
authors.forename: Bita
authors.initials: B
authors.lastname: Rahbari
authors.forename: Parastoo
authors.initials: P
authors.lastname: Chaichi
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Badiee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007792:Lactulose / Q000627:therapeutic use*; D007962:Leukocytes / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010976:Platelet Count; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000188:drug therapy; D012964:Sodium / Q000097:blood; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D015415:Biomarkers; D005765:Gastrointestinal Agents; D006454:Hemoglobins; D008055:Lipids; D010281:Parathyroid Hormone; D001613:beta 2-Microglobulin; D014527:Uric Acid; D007792:Lactulose; D012964:Sodium; D003404:Creatinine; D011188:Potassium