Efficacy of probiotic supplementation in patients with diabetic nephropathy: A systematic review and meta-analysis

AbdelQadir, Yossef Hassan; Hamdallah, Aboalmagd; Sibaey, Esraa Alsayed; Hussein, Alyaa Sayed; Abdelaziz, Muhammad; AbdelAzim, Ahmed Alaa; Ragab, Khaled Mohamed; Helmy, Sara Kamel; Nourelden, Anas Zakarya

doi:10.1016/j.clnesp.2020.06.019

Cited by 25 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In line with a previous systematic review (72) , we found probiotic/synbiotic supplementation may improve creatinine levels in patients with renal dysfunction. Although, a meta-analysis by AbdelQadir etal., showed despite a significant improvement in antioxidant indices, there is no association between probiotic supplementation and creatinine, GFR, or BUN levels in patients with diabetic nephropathy (73) . It may be contributed to misclassification of the study by Firouzi etal., (60) which the nephropathy was an exclusion criterion of this study, but it has been included in the analysis.…”

Section: Discussionmentioning

confidence: 92%

“…As far as we are aware, this is the first meta-analysis comprehensively investigating the effect of probiotics/synbiotics supplementation on kidney and liver function in patients with type 2 diabetes. However, one previous meta-analysis study investigated the effect of probiotic supplementation on kidney function in patients with diabetic nephropathy, with non-significant results (73) . Pooling data from good quality RCTs permits causal associations to be drawn; however, there are some considerable limitations.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

The effect of probiotics/synbiotics supplementation on renal and liver biomarkers in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials

et al. 2021

View full text Add to dashboard Cite

Despite the apparent beneficial effects of probiotics/synbiotics on glucose hemostasis, lipid profile, and inflammatory responses, it is not clear whether these beneficial effects also impact renal and hepatic function in diabetes. Therefore, we sought to assess the effect of probiotics/synbiotics supplementation on renal and liver biomarkers in adults with type 2 diabetes (T2DM) using a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched, up to February 2021. The pooled weighted mean difference (WMD) was estimated using a random-effect model. The methodological quality of studies, as well as certainty of evidence, was assessed using standard scales. Fifteen related trials were identified. Meta-analysis of six trials, involving 426 participants, indicated that probiotics/synbiotics supplementation reduced serum levels of creatinine (WMD= −0.10 mg/dl, 95% CI: −0.20, −0.00; P= 0.01; I 2 = 87.7%; P-heterogeneity<0.001), without any significant effect on blood urea nitrogen (BUN), glomerular filtration rate, or microalbuminuria. No significant improvement was found on liver biomarkers following probiotics/synbiotics supplementation. The subgroup analysis showed a significant improvement in BUN when follow-up duration lasted for 12 weeks or more (WMD= −1.215 mg/dl, 95% CI: −1.933, −0.496 ; P= 0.001), and in creatinine levels in patients with renal dysfunction (WMD= −0.209 mg/dl, 95% CI: −0.322, −0.096; P<0.001). Our results are insufficient to advocate the use of probiotics/synbiotics for improving renal or liver function in patients with T2DM. Indeed, due to the low certainty of evidence, these findings need to be affirmed in further high-quality RCTs.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Strengths and Limitationsmentioning

confidence: 99%

The effect of probiotics/synbiotics supplementation on renal and liver biomarkers in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Based on our knowledge, this study is the first meta-analysis on the antioxidant and anti-inflammatory effects of probiotics supplementation in DN patients. Recently, a meta-analysis was conducted by AbdelQadir and colleagues [ 32 ] in DN patients. They included three trials to evaluate the effect of probiotics on hs-CRP and oxidative stress biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Effect of probiotics on oxidative stress and inflammatory status in diabetic nephropathy: A systematic review and meta-analysis of clinical trials

Bohlouli

Namjoo

Borzoo-Isfahani

et al. 2021

Heliyon

View full text Add to dashboard Cite

“…A systematic review of Vlachou in animal and clinical studies [ 9 ] found that probiotics on subjects with DKD had significant alterations in biomarkers of inflammation and renal function in other biomarkers such as fasting plasma glucose (FPG), homeostasis model of assessment-estimated insulin resistance (HOMA-IR), increased quantitative insulin sensitivity check index (QUICKI), insulin, triglycerides (TG), very low-density lipoprotein cholesterol (VLDL-c) and high-density lipoprotein cholesterol (HDL-c) levels. However, the meta of Moravejolahkami [ 10 ] and AbdelQadir [ 11 ] demonstrated that probiotics had no beneficial effect on patients with DKD regarding lipid profiles such as TG, total cholesterol (TC), VLDL-c, HDL-c levels, and oxidative stress such as nitric oxide (NO), glutathione (GSH). Tarrahi [ 12 ] showed that there was no statistically significant change in hemoglobin A1c (HbA1c), insulin, QUICKI, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) in patients with DKD.…”

mentioning

confidence: 99%

Probiotics improve renal function, glucose, lipids, inflammation and oxidative stress in diabetic kidney disease: a systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

Aims The role of probiotics in the management of diabetic kidney disease (DKD) has been shown. Several current trials are investigating the effect of probiotics, which are widely used to modulate biomarkers of renal function, glucose, lipids, inflammation and oxidative stress in patients with DKD. However, their findings are controversial. This study aimed to systematically evaluate the impact of probiotics on patients with DKD via meta-analysis. Methods PubMed, The Cochrane Library, Web of Science, Scopus, Embase, China National Knowledge Infrastructure, Chinese Wanfang Database and Chinese VIP Database were searched for relevant studies from the establishment of these databases to September 2021. The pooled results evaluated the impact of probiotics on renal function, glucose, lipids, inflammation and oxidative stress indicators in patients with DKD. Additionally, subgroup analysis was performed based on intervention duration, probiotic dose and probiotic consumption patterns, respectively. Results Ten trials that included 552 participants were identified for analysis. Compared with the controls, probiotics significantly decreased serum creatinine (Scr) [WMD = −0.17 mg/dL; 95%CI = −0.29, −0.05; p = 0.004], blood urea nitrogen (BUN) [WMD = −1.36 mg/dL; 95%CI = −2.20, −0.52; p = 0.001], cystatin C (Cys C) [WMD = −29.50 ng/mL; 95%CI = −32.82, −26.18; p < 0.00001], urinary albumin/creatinine ratio (UACR) [WMD = −16.05 mg/g; 95%CI = −27.12, −4.99; p = 0.004] and natrium (Na) [WMD = −0.94 mmol/L; 95%CI = −1.82, −0.05; p = 0.04] in patients with DKD. Enhanced glycemic control was observed in patients with DKD receiving probiotics compared with controls, as demonstrated by reduced levels of fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), homeostasis model of assessment-estimated insulin resistance (HOMA-IR), and increased quantitative insulin sensitivity check index (QUICKI). Probiotics affected lipid metabolism parameters with decreasing triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels in patients with DKD. Probiotics could also could improve inflammation and oxidative stress by decreasing high-sensitivity C-reactive protein (hs-CRP), plasma malondialdehyde (MDA), total antioxidant capacity (TAC), glutathione (GSH) and nitric oxide (NO). Additionally, subgroup analysis showed that those who received multiple species probiotics had a statistically significant difference in BUN, FPG, HOMA-IR, high-density lipoprotein cholesterol (HDL-c), MDA, TAC, and NO. Meanwhile, Scr, LDL-c, HDL-c, MDA, and TAC were ameliorated when the intervention duration was more than eight weeks and BUN, FPG, HOMA-IR, and MDA were improved when the probiotic dose was greater than four billion CFU/day. Conclusions ...

show abstract

Efficacy of probiotic supplementation in patients with diabetic nephropathy: A systematic review and meta-analysis

Cited by 25 publications

References 24 publications

The effect of probiotics/synbiotics supplementation on renal and liver biomarkers in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials

The effect of probiotics/synbiotics supplementation on renal and liver biomarkers in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials

Effect of probiotics on oxidative stress and inflammatory status in diabetic nephropathy: A systematic review and meta-analysis of clinical trials

Probiotics improve renal function, glucose, lipids, inflammation and oxidative stress in diabetic kidney disease: a systematic review and meta-analysis

Contact Info

Product

Resources

About