The Efficacy of Lactobacillus-Containing Probiotic Supplementation in Hemodialysis Patients: A Randomized, Double-Blind, Placebo-Controlled Trial

Lim, Paik‐Seong; Wang, Hsueh Fang; Lee, Mei‐Chen; Chiu, Li-Shu; Wu, Ming-Ying; Chang, Wui-Chen; Wu, Tsai Kun

doi:10.1053/j.jrn.2020.07.002

Cited by 21 publications

(15 citation statements)

References 71 publications

(82 reference statements)

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“…The hemodialysis duration of all participants with mean age ranging from 32 to 63 years is presented in Table 1 . The shortest duration of intervention was 4 weeks [ 20 , 21 , 22 , 23 ], and the longest was 24 weeks [ 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…A previous review conducted an analysis based on the post-intervention data, whereas we collected the means and SDs of the changes between the baseline and final values, which yielded a significant difference in the pooled IS data of Borges et al’s trial [ 32 ]. Notably, three recent trials have been added to our assessment [ 21 , 25 , 42 ]. It is worth noting that, in a subgroup review of studies that focused on intervention therapy, we discovered that prebiotics have a significant effect on reducing IS.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Probiotics, Prebiotics, and Synbiotics on Uremic Toxins, Inflammation, and Oxidative Stress in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nguyen

Kim

2021

JCM

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The dysbiosis of gut microbiota may cause many complications in patients with end-stage renal disease, which may be alleviated by probiotic, prebiotic, and synbiotic supplementation. The aim of this systematic review and meta-analysis was to assess the effects of these supplementations on circulatory uremic toxins, biomarkers of inflammation, and oxidative stress in hemodialysis patients. We searched the EMBASE, MEDLINE, Web of Science, and Cochrane Library databases until 8 August 2021. Randomized controlled trials evaluating adult patients receiving hemodialysis were included. The pooled results from 23 studies with 931 hemodialysis patients indicated that interventions significantly decreased the circulating levels of p-cresyl sulfate (standardized mean difference (SMD): 0.38; 95% CI: −0.61, −0.15; p = 0.001), endotoxins (SMD: −0.58; 95% CI: −0.99, −0.18; p = 0.005), malondialdehyde (SMD: −1.16; 95% CI: −1.81, −0.52; p = 0.0004), C-reactive proteins (CRP) (SMD: −0.61; 95% CI: −0.99, −0.23; p = 0.002), and interleukin 6 (SMD: −0.92; 95% CI: −1.51, −0.33; p = 0.002), and improved the total antioxidant capacity (SMD: 0.89; 95% CI: 0.49, 1.30; p < 0.0001) and glutathione (SMD: 0.40; 95% CI: 0.14, 0.66; p = 0.003) when compared to the placebo group. Our results suggest that treatment with probiotics, prebiotics, and synbiotics may help alleviate uremic toxin levels, oxidative stress, and the inflammatory status in hemodialysis patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of Probiotics, Prebiotics, and Synbiotics on Uremic Toxins, Inflammation, and Oxidative Stress in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nguyen

Kim

2021

JCM

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“…While we await direct research of plant-based diets on TMAO production in CKD, we can contemplate the results of the study by Lim et al 17 also published in this issue. In their randomized, double-blind, placebo-controlled trial, Lim et al 17 evaluated the effect of a probiotic supplement on various biomarkers in a group of 56 patients on hemodialysis. The study demonstrated that 6 months of probiotic supplementation did not affect hemoglobin, blood urea nitrogen, blood sugar, inflammatory markers, or p-cresyl sulfate, a uremic toxin.…”

mentioning

confidence: 97%

The Future of Nutrition in Kidney Disease: Plant-Based Diets, Gut Microbiome, and Beyond

Joshi

Moore

Kalantar-Zadeh

2021

Journal of Renal Nutrition

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“…These trials evaluated 4 different treatment agents, including probiotics, prebiotics, synbiotics, and placebo. Out of 25 studies, nine studies ( 22 , 25 , 26 , 30 , 32 , 34 , 36 , 39 , 40 ) compared prebiotics with placebo, nine studies ( 16 , 21 , 24 , 27 – 29 , 37 , 41 , 42 ) compared probiotics with placebo, six studies ( 15 , 20 , 23 , 33 , 35 , 38 ) compared synbiotics with placebo as well as one study ( 31 ) was three-arm RCT that compared probiotics, synbiotics and placebo.…”

Section: Resultsmentioning

confidence: 99%

Probiotics, Prebiotics, and Synbiotics Improve Uremic, Inflammatory, and Gastrointestinal Symptoms in End-Stage Renal Disease With Dialysis: A Network Meta-Analysis of Randomized Controlled Trials

Jin

Qin

et al. 2022

Front. Nutr.

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BackgroundProbiotics, prebiotics, and synbiotics are three different supplements to treat end stage renal disease (ESRD) patients by targeting gut bacteria. The comprehensive comparison of the effectiveness of different supplements are lacking.ObjectivesThe purpose of this network meta-analysis (NMA) is to assess and rank the efficacy of probiotics, prebiotics, and synbiotics on inflammatory factors, uremic toxins, and gastrointestinal symptoms (GI symptoms) in ESRD patients undergoing dialysis.MethodsRandomized clinical trials were searched from the PubMed, Embase, and Cochrane Register of Controlled Trials databases, from their inception until 4 September 2021. Random-effect model were used to obtain all estimated outcomes in network meta-analysis (NMA). Effect estimates were presented as mean differences (Mean ± SD) with 95% confidence interval (CI). The comprehensive effects of all treatments were ranked by the surface under the cumulative ranking (SUCRA) probabilities.ResultsTwenty-five studies involved 1,106 participants were included. Prebiotics were superior in decreasing Interleukin-6 (IL-6; SMD –0.74, 95% CI [–1.32, –0.16]) and tumor-necrosis factor-α (TNF-α; SMD –0.59, 95% CI [–1.09, –0.08]), synbiotics were more effective in declining C-reactive protein (CRP; SMD –0.69, 95% CI [–1.14, –0.24]) and endotoxin (SMD –0.83, 95% CI [–1.38, –0.27]). Regarding uremic toxins, prebiotics ranked highest in reducing indoxyl sulfate (IS; SMD –0.43, 95% CI [–0.81, –0.05]), blood urea nitrogen (BUN; SMD –0.42, 95% CI [–0.78, –0.06]), and malondialdehyde (MDA; SMD –1.88, 95% CI [–3.02, –0.75]). Probiotics were rated as best in alleviating GI symptoms (SMD: –0.52, 95% CI [–0.93, –0.1]).ConclusionOur research indicated prebiotics were more effective in declining IL-6, TNF-α, IS, MDA, and BUN, synbiotics lowering CRP and endotoxin significantly, and probiotics were beneficial for alleviating GI symptoms, which may contribute to better clinical decisions. This study was registered in PROSPERO (Number: CRD42021277056).Systematic Review Registration[http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42021277056].

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The Efficacy of Lactobacillus-Containing Probiotic Supplementation in Hemodialysis Patients: A Randomized, Double-Blind, Placebo-Controlled Trial

Cited by 21 publications

References 71 publications

Effects of Probiotics, Prebiotics, and Synbiotics on Uremic Toxins, Inflammation, and Oxidative Stress in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effects of Probiotics, Prebiotics, and Synbiotics on Uremic Toxins, Inflammation, and Oxidative Stress in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The Future of Nutrition in Kidney Disease: Plant-Based Diets, Gut Microbiome, and Beyond

Probiotics, Prebiotics, and Synbiotics Improve Uremic, Inflammatory, and Gastrointestinal Symptoms in End-Stage Renal Disease With Dialysis: A Network Meta-Analysis of Randomized Controlled Trials

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