The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials
Context: There is mounting evidence suggesting bidirectional crosstalk between microbiota and host. However, the effects of probiotics on renal function and uremic toxins in chronic kidney disease (CKD) patients are unclear. Evidence Acquisitions: A literature review was conducted using MEDLINE, EMB...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Society of Diabetic Nephropathy Prevention
2018-07-01
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| Series: | Journal of Nephropathology |
| Subjects: | |
| Online Access: | https://nephropathol.com/PDF/jnp-7-106.pdf |
| _version_ | 1797828017095966720 |
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| author | Charat Thongprayoon Spencer T. Hatch Wisit Kaewput Konika Sharma Patompong Ungprasert Karn Wijarnpreecha Matthew D’Costa Michael A Mao Wisit Cheungpasitporn |
| author_facet | Charat Thongprayoon Spencer T. Hatch Wisit Kaewput Konika Sharma Patompong Ungprasert Karn Wijarnpreecha Matthew D’Costa Michael A Mao Wisit Cheungpasitporn |
| author_sort | Charat Thongprayoon |
| collection | DOAJ |
| description | Context: There is mounting evidence suggesting bidirectional crosstalk between microbiota and host. However, the effects of probiotics on renal function and uremic toxins in chronic kidney disease (CKD) patients are unclear. Evidence Acquisitions: A literature review was conducted using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through November 2017 to identify randomized controlled trials (RCTs) assessing the effects of probiotics on renal function and uremic toxins in CKD patients. Effect estimates from the individual studies were extracted and combined using fixed-effect meta-analysis with inverse variance weights. Results: Five RCTs with 161 CKD patients were enrolled. Compared to controls, there were no significant differences in serum creatinine and estimated glomerular filtration rate (eGFR) after post-probiotic course (4 weeks to 6 months) with standardized mean differences (SMDs) of 0.01 (95% CI -0.29 to 0.30) and -0.01 (95% CI -0.43 to 0.41), respectively. Compared to the controls, p-cresol levels were significantly reduced after treatment with probiotics with SMD of -0.61 (95% CI -1.04 to -0.19). No significant infectious complications were noted during treatment with probiotics in CKD patients. Conclusions: Based on the findings of our meta-analysis, there are no significant changes in serum creatinine or eGFR after short-term treatment with probiotics, when compared to controls. However, our meta-analysis suggests potential beneficial effects of probiotics on uremic toxins in CKD patients. Future studies are required to assess its long-term effects on CKD progression and uremic toxins. |
| first_indexed | 2024-04-09T12:57:43Z |
| format | Article |
| id | doaj.art-f8dba86cf52744d3bdfe7ed577fa12ad |
| institution | Directory Open Access Journal |
| issn | 2251-8363 2251-8819 |
| language | English |
| last_indexed | 2024-04-09T12:57:43Z |
| publishDate | 2018-07-01 |
| publisher | Society of Diabetic Nephropathy Prevention |
| record_format | Article |
| series | Journal of Nephropathology |
| spelling | doaj.art-f8dba86cf52744d3bdfe7ed577fa12ad2023-05-13T11:29:32ZengSociety of Diabetic Nephropathy PreventionJournal of Nephropathology2251-83632251-88192018-07-017310611410.15171/jnp.2018.25jnp-20180704100930The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trialsCharat Thongprayoon0Spencer T. Hatch1Wisit Kaewput2Konika Sharma3Patompong Ungprasert4Karn Wijarnpreecha5Matthew D’Costa6Michael A Mao7Wisit Cheungpasitporn8Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USADivision of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USADepartment of Military and Community Medicine, Phramongkutklao College of Medicine Bangkok, ThailandDepartment of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USAClinical Epidemiology Unit, Department of Research and development, Faculty of Medicine Siriraj Hospital, Mahidol University, ThailandDepartment of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USADivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USADivision of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USADivision of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USAContext: There is mounting evidence suggesting bidirectional crosstalk between microbiota and host. However, the effects of probiotics on renal function and uremic toxins in chronic kidney disease (CKD) patients are unclear. Evidence Acquisitions: A literature review was conducted using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through November 2017 to identify randomized controlled trials (RCTs) assessing the effects of probiotics on renal function and uremic toxins in CKD patients. Effect estimates from the individual studies were extracted and combined using fixed-effect meta-analysis with inverse variance weights. Results: Five RCTs with 161 CKD patients were enrolled. Compared to controls, there were no significant differences in serum creatinine and estimated glomerular filtration rate (eGFR) after post-probiotic course (4 weeks to 6 months) with standardized mean differences (SMDs) of 0.01 (95% CI -0.29 to 0.30) and -0.01 (95% CI -0.43 to 0.41), respectively. Compared to the controls, p-cresol levels were significantly reduced after treatment with probiotics with SMD of -0.61 (95% CI -1.04 to -0.19). No significant infectious complications were noted during treatment with probiotics in CKD patients. Conclusions: Based on the findings of our meta-analysis, there are no significant changes in serum creatinine or eGFR after short-term treatment with probiotics, when compared to controls. However, our meta-analysis suggests potential beneficial effects of probiotics on uremic toxins in CKD patients. Future studies are required to assess its long-term effects on CKD progression and uremic toxins.https://nephropathol.com/PDF/jnp-7-106.pdfprobioticsrenal functioncreatininechronic kidney diseaseckdgut microbiome |
| spellingShingle | Charat Thongprayoon Spencer T. Hatch Wisit Kaewput Konika Sharma Patompong Ungprasert Karn Wijarnpreecha Matthew D’Costa Michael A Mao Wisit Cheungpasitporn The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials Journal of Nephropathology probiotics renal function creatinine chronic kidney disease ckd gut microbiome |
| title | The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials |
| title_full | The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials |
| title_fullStr | The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials |
| title_full_unstemmed | The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials |
| title_short | The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials |
| title_sort | effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease a meta analysis of randomized controlled trials |
| topic | probiotics renal function creatinine chronic kidney disease ckd gut microbiome |
| url | https://nephropathol.com/PDF/jnp-7-106.pdf |
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