Effect of probiotics on serum indoxyl sulphate in haemodialysis patients

The Efficacy of Prebiotic, Probiotic, and Synbiotic Supplementation in Modulating Gut-Derived Circulatory Particles Associated With Cardiovascular Disease in Individuals Receiving Dialysis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Twenty-one trials, available as twenty-four reports were eligible (1152 randomised participants) for the review (see Table 1). Three conference abstracts were included [28][29][30] with data for gastrointestinal symptoms provided by the authors from one of these trials 30 . Intervention duration ranged from 2-24 weeks.…”

“…Seven trials tested prebiotics 18,30,31,35,37,40,41 seven trials tested probiotics 15,17,22,29,33,34,36,39 , while six trials tested synbiotics 16,19,20,23,28,32,38 , and one trial 13,14 tested both probiotics and synbiotics. Eighteen trials were parallel-group randomised controlled trials, while three were randomised controlled crossover trials (Table 1).…”

“…Risk of bias summaries are provided in Figure 2. The three included conference abstracts [28][29][30] were not included in the risk of bias assessment due to insufficient published detail on trial methodology. All trials with the exception of two 16,36 were rated as either moderate or high risk of bias.…”

“…A significant reduction in endotoxin (-0.53, -0.98 to -0.09, P=0.02, I 2 =0%) was still observed for probiotic data only 14,22 . For indoxyl-sulphate, data for synthesis was unavailable from three trials due to insufficient reporting 28,29,33 . Therefore, four randomised controlled trials 18,20,35,39 (175 participants) including prebiotic 18,35 , probiotic 39 and synbiotic 20 supplementation were meta-analysed and indicated a significant reduction (-0.34, -0.64 to -0.04, P=0.02, I 2 =0%) (Figure 4).…”

“…Fourteen trials (15 records) reported measurement of CRP 14, 16-19, 23, 28, 29, 33-39 . Data from four trials could not be included in a meta-analysis as a result of insufficient reporting 28,29,33,38 . Substantial heterogeneity (I 2 =69%) was present among the remaining ten trials (502 participants) 14,16,18,19,23,[34][35][36][37]39 , therefore a meta-analysis was deemed inappropriate.…”