Clinical Study Gum Arabic Reduces C-Reactive Protein in Chronic Kidney Disease Patients without Affecting Urea or Indoxyl Sulfate Levels Sarra Elamin, Mariam J. Alkhawaja, Amina Y. Bukhamsin, Mohamed A. S. Idris, Muntasir M. Abdelrahman, Nasrulla K. Abutaleb, and Abdulrahman A. Housawi King Fahad Specialist Hospital, Dammam 31444, Saudi Arabia Correspondence should be addressed to Sarra Elamin; sarraelamin@hotmail.com Received 28 February 2017; Revised 5 April 2017; Accepted 19 April 2017; Published 14 May 2017 Academic Editor: Francesca Mallamaci Copyright © 2017 Sarra Elamin et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Gum Arabic (GA) is a complex polysaccharide with proven prebiotic properties and potentially benefcial systemic efects. Methods. We randomly allocated 36 chronic kidney disease (CKD) patients to receive 10, 20, or 40 grams daily of GA for four weeks and studied the systemic efects of this intervention. Results. Tirty participants completed the study with baseline glomerular fltration rate 29.1 ± 9.9 mL/min/1.7 m 2 . In contrast to previous observations, we found no efect on serum urea or creatinine levels. GA supplementation was associated with a small but statistically signifcant drop in serum sodium level (138±2 to 136±3 mmol/L,  = 0.002) without afecting other electrolytes, urine volume, or indoxyl sulfate (IS) levels. GA supplementation was also associated with a signifcant drop in C-reactive protein (CRP) level (3.5 ± 1.5 to 2.8 ± 1.6 ng/mL,  = 0.02) even in patients who received only 10 g/day (4.4 ± 1.2 to 3.2 ± 1.5 ng/mL,  = 0.03). Conclusions. Supplementing the diet of CKD patients with 10–40g/day of GA signifcantly reduced CRP level which could have a positive impact on these patients’ morbidity and mortality. Tis trial is registered with Saudi Clinical Trial Registry number 15011402. 1. Introduction Chronic kidney disease (CKD) patients sufer from a persis- tent state of chronic infammation and the gastrointestinal tract is a potential source for this infammation. Uremia is associated with greatly increased bacterial counts in the duodenum and jejunum, higher prevalence of pathogenic bacteria in stool, and impaired intestinal barrier function [1]. Te reasons behind this disruption of the intestinal microbiome are multifold. High concentrations of urea dif- fuse into the colon and provide a rich substrate for microbial multiplication. Impaired protein dissimilation in the small intestine allows signifcant amounts of protein to reach the colon, selectively encouraging the growth of proteolytic bacteria. Constipation allows more time for amino acid fermentation to occur in the colon and further encourages the growth of pathogenic bacteria [1]. Te byproducts of amino acid fermentation difuse from the colon into the circulation. Because of diminished renal clearance, their levels exhibit an exponential rise in patients with advanced renal insufciency. Researchers have been focusing on two such uremic retention molecules; indoxyl sulfate (IS) and p-cresyl sulfate (PCS) [2]. Both toxins have been associated with renal function deterioration, cardiovas- cular disease, and overall mortality in the CKD population [3, 4]. Consequently, the intestinal microbiome is a potentially useful target for therapeutic interventions in CKD patients. Twenty years ago, Bliss et al. [5] demonstrated that supple- menting the diet of CKD patients with a highly fermentable fber (50 g/day) increased fecal bacteria mass by 50%, increased fecal nitrogen content by 41%, and reduced blood urea nitrogen (BUN) concentration by 12%. More recently, analyzing data from the National Health and Nutrition Examination Survey III demonstrated that high fber intake was inversely related to C-reactive protein (CRP) levels and mortality in subjects with kidney disease [6]. Tis caused Hindawi International Journal of Nephrology Volume 2017, Article ID 9501470, 6 pages https://doi.org/10.1155/2017/9501470