Clinical and experimental use of probiotic formulations for management of end-stage renal disease: an update

Cerbo, Alessandro Di; Pezzuto, Federica; Palmieri, Lucia; Rottigni, Valentina; Iannitti, Tommaso; Palmieri, Beniamino

doi:10.1007/s11255-012-0335-5

Cited by 26 publications

(18 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The application of probiotics in various diseases has intensified, as extensive research efforts help understand how they shape human health and how their composition changes in diseased states [43]. The application of probiotics in ESRD management has been investigated in both experimental and clinical settings [44]. Recently, deeper insight was gained into probiotics' positive effects on kidney disease progression—possible mechanisms include anti-inflammatory (addressing imbalances of gut dysbiosis) and antioxidant (addressing deficiencies in free radical signaling—generation of reactive oxygen species in the gut) routes [45].…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

Ranganathan

Pechenyak

Vyas

et al. 2014

BioMed Research International

111

113

View full text Add to dashboard Cite

Background. Primary goal of this randomized, double-blind, placebo-controlled crossover study of Renadyl in end-stage renal disease patients was to assess the safety and efficacy of Renadyl measured through improvement in quality of life or reduction in levels of known uremic toxins. Secondary goal was to investigate the effects on several biomarkers of inflammation and oxidative stress. Methods. Two 2-month treatment periods separated by 2-month washout and crossover, with physical examinations, venous blood testing, and quality of life questionnaires completed at each visit. Data were analyzed with SAS V9.2. Results. 22 subjects (79%) completed the study. Observed trends were as follows (none reaching statistical significance): decline in WBC count (−0.51 × 109/L, P = 0.057) and reductions in levels of C-reactive protein (−8.61 mg/L, P = 0.071) and total indoxyl glucuronide (−0.11 mg%, P = 0.058). No statistically significant changes were observed in other uremic toxin levels or measures of QOL. Conclusions. Renadyl appeared to be safe to administer to ESRD patients on hemodialysis. Stability in QOL assessment is an encouraging result for a patient cohort in such advanced stage of kidney disease. Efficacy could not be confirmed definitively, primarily due to small sample size and low statistical power—further studies are warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

Ranganathan

Pechenyak

Vyas

et al. 2014

BioMed Research International

111

113

View full text Add to dashboard Cite

show abstract

“…A strong interest to probiotic use in CKD/ESRD emerged in recent years, and various outcomes have been investigated [76,77]. An anti-inflammatory effect of probiotics currently has been demonstrated in animal models [78], but sufficiently powered clinical studies are still lacking [51].…”

Section: Correction Of Inflammation In Ckdmentioning

confidence: 99%

Update on Inflammation in Chronic Kidney Disease

2015

View full text Add to dashboard Cite

Background: Despite recent advances in chronic kidney disease (CKD) and end-stage renal disease (ESRD) management, morbidity and mortality in this population remain exceptionally high. Persistent, low-grade inflammation has been recognized as an important component of CKD, playing a unique role in its pathophysiology and being accountable in part for cardiovascular and all-cause mortality, as well as contributing to the development of protein-energy wasting. Summary: The variety of factors contribute to chronic inflammatory status in CKD, including increased production and decreased clearance of pro-inflammatory cytokines, oxidative stress and acidosis, chronic and recurrent infections, including those related to dialysis access, altered metabolism of adipose tissue, and intestinal dysbiosis. Inflammation directly correlates with the glomerular filtration rate (GFR) in CKD and culminates in dialysis patients, where extracorporeal factors, such as impurities in dialysis water, microbiological quality of the dialysate, and bioincompatible factors in the dialysis circuit play an additional role. Genetic and epigenetic influences contributing to inflammatory activation in CKD are currently being intensively investigated. A number of interventions have been proposed to target inflammation in CKD, including lifestyle modifications, pharmacological agents, and optimization of dialysis. Importantly, some of these therapies have been recently tested in randomized controlled trials. Key Messages: Chronic inflammation should be regarded as a common comorbid condition in CKD and especially in dialysis patients. A number of interventions have been proven to be safe and effective in well-designed clinical studies. This includes such inexpensive approaches as modification of physical activity and dietary supplementation. Further investigations are needed to evaluate the effects of these interventions on hard outcomes, as well as to better understand the role of inflammation in selected CKD populations (e.g., in children).

show abstract

“…190 Many studies support the probiotic approach as an alternative therapy for management of end-stage renal disease 191 and to relieve the 'uraemic' condition. 189 192-194 In particular, a high urease activity was observed for S. spp, L. casei, K. aerogenes and Enterococcus faecium in the sheep rumen.…”

Section: Kidney Diseasementioning

confidence: 99%

Mechanisms and therapeutic effectiveness of lactobacilli

et al. 2015

Self Cite

View full text Add to dashboard Cite

The gut microbiome is not a silent ecosystem but exerts several physiological and immunological functions. For many decades, lactobacilli have been used as an effective therapy for treatment of several pathological conditions displaying an overall positive safety profile. This review summarises the mechanisms and clinical evidence supporting therapeutic efficacy of lactobacilli. We searched Pubmed/Medline using the keyword ‘Lactobacillus’. Selected papers from 1950 to 2015 were chosen on the basis of their content. Relevant clinical and experimental articles using lactobacilli as therapeutic agents have been included. Applications of lactobacilli include kidney support for renal insufficiency, pancreas health, management of metabolic imbalance, and cancer treatment and prevention. In vitro and in vivo investigations have shown that prolonged lactobacilli administration induces qualitative and quantitative modifications in the human gastrointestinal microbial ecosystem with encouraging perspectives in counteracting pathology-associated physiological and immunological changes. Few studies have highlighted the risk of translocation with subsequent sepsis and bacteraemia following probiotic administration but there is still a lack of investigations on the dose effect of these compounds. Great care is thus required in the choice of the proper Lactobacillus species, their genetic stability and the translocation risk, mainly related to inflammatory disease-induced gut mucosa enhanced permeability. Finally, we need to determine the adequate amount of bacteria to be delivered in order to achieve the best clinical efficacy decreasing the risk of side effects.

show abstract

Clinical and experimental use of probiotic formulations for management of end-stage renal disease: an update

Cited by 26 publications

References 50 publications

Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

Update on Inflammation in Chronic Kidney Disease

Mechanisms and therapeutic effectiveness of lactobacilli

Contact Info

Product

Resources

About