Biotic Supplements in Patients With Chronic Kidney Disease: Meta-Analysis of Randomized Controlled Trials - Journal of Renal Nutrition. A Renal Clinician's Guide to the Gut Microbiota - Journal of Renal Nutrition. Marteau P. Lepage P. Mangin I. et al.Gut flora and inflammatory bowel disease.Aliment Pharmacol Ther. 2004; 20: 18-23Wang Z. Klipfell E. Bennett B.J. et al.Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.Nature. 2011; 472: 57-63Vaziri N.D. Wong J. Pahl M. et al.Chronic kidney disease alters intestinal microbial flora.Kidney Int. 2013; 83: 308-315Ley R.E. Intestinal microbiota alterations in chronic kidney disease and the influence of dietary components: Critical Reviews in Food Science and Nutrition: Vol 0, No 0.
In chronic kidney disease, as in many other diseases, dysbiosis of intestinal microbiota has been reported as a disturbance or imbalance of the normal microbiome content that could disrupt the symbiotic relationship between the host and associated microbes, a disruption that can result in diseases. The disruption of gut barrier function allows the translocation of endotoxins and bacterial metabolites to the organism, thus contributing to uremic toxicity, inflammation and progression of chronic kidney disease. Increased intake of some nutrients and different nutritional strategies have been proposed to modulate gut microbiota, thus offering the opportunity for therapeutic interventions modifying the diet, decreasing uremic toxins production, increasing toxin excretion and finally modifying the normal microbiome content.
Benefits of Probiotic Consumption on Chronic Kidney Disease - Journal of Renal Nutrition. According to the Office of Disease Prevention and Health Promotion, Medicare spends approximately 25% of its money on treatment for patients with chronic kidney disease (CKD) and end-stage renal disease. Healthy People 2020Chronic Kidney Disease 2019.
This disease impacts nearly 30 million American adults, with many more at risk of developing the disease. National Kidney FoundationAbout Chronic Kidney Disease. Treatment for these patients includes diet modification, lifestyle changes, renal replacement therapy, and kidney transplantation. CKD can lead to many complications in patients including gut microbiota alterations. Zirker L. The Relationship between gut microbiota and CKD: Why use prebiotics in CKD patients?. Ren Nutr Forum. 2014; 33: 1-7 The slowed transit time through the gastrointestinal (GI) tract associated with constipation may contribute to dysbiosis due to bacterial overgrowth in the stool. Wing M.R. Gut microbiome in chronic kidney disease.
Exp Physiol. 2016; 101: 471-477 Sobol H. Dietary Fiber and Gut Microbiota in Renal Diets. The Role of Gut Microbiota and Diet on Uremic Retention Solutes Production in the Context of Chronic Kidney Disease. Recently, large systemic studies revealed that a healthy diet including many fruits and vegetables, fish, legumes, whole grains, and fibers and also a cutting down on red meat, sodium, and refined sugar intake were associated with a decreased risk of incident CKD for participants consuming the highest quartile of vegetable proteins [26] and a lower mortality in CKD patients [27]. In contrast, red meat intake increased the risk for developing end-stage renal disease [28]. A kidney-friendly diet could help to protect renal function from further damage and a dataset seems to indicate that CKD and its related complications are the consequence of the modification of the intestinal microbiota and the production of URS.
Unfortunately, despite the fact that the deleterious influence of certain types of diet/nutrients composition on URS generation has been identified, very few studies explored the impact of this specific diet on CKD progression and patient survival. 4.1. 4.2. Efficacy of Probiotics Supplementation On Chronic Kidney Disease: a Systematic Review and Meta-Analysis. Prebiotic, Probiotic, and Synbiotic Supplementation in Chronic Kidney Disease: A Systematic Review and Meta-analysis - Journal of Renal Nutrition.
Prebiotic, Probiotic, and Synbiotic Supplementation in Chronic Kidney Disease: A Systematic Review and Meta-analysis - Journal of Renal Nutrition. Sixteen studies investigating 645 adults met the inclusion criteria; 5 investigated prebiotics, 6 probiotics, and 5 synbiotics. The quality of the studies (Grades of Recommendation, Assessment, Development and Evaluation) ranged from moderate to very low. Prebiotic, probiotic, and synbiotic supplementation may have led to little or no difference in serum urea (9 studies, 345 participants: mean difference [MD] −0.30 mmol/L, 95% confidence interval [CI] −2.20 to 1.61, P = .76, I2 = 53%), indoxyl sulfate (4 studies, 144 participants: MD −0.02 mg/dL, 95% CI −0.09 to 0.05, P = .61, I2 = 0%), and p-cresyl sulfate (4 studies, 144 participants: MD −0.13 mg/dL, 95% CI −0.41 to 0.15, P = .35, I2 = 0%).
Prebiotic supplementation may have slightly reduced serum urea concentration (4 studies, 105 participants: MD −2.23 mmol/L, 95% CI −3.83 to −0.64, P = .006, I2 = 11). Of the 2 studies investigating microbiota changes, synbiotic interventions significantly increased Bifidobacterium. Modulation of the Gut Microbiota by Resistant Starch as a Treatment of Chronic Kidney Diseases: Evidence of Efficacy and Mechanistic Insights | Advances in Nutrition. Dietary Components That May Influence the Disturbed Gut Microbiota in Chronic Kidney Disease. Moderate Renal Impairment and Toxic Metabolites Produced by the Intestinal Microbiome: Dietary Implications - Journal of Renal Nutrition. Effects of probiotic supplements on the progression of chronic kidney disease: a meta‐analysis - Tao - - Nephrology. Background Chronic kidney disease (CKD) is a worldwide public health problem. Although accumulated data suggested that probiotic supplements played roles in CKD, the results remained controversial.
Here we performed a meta‐analysis to assess the effects of probiotic supplements on the CKD progression. Methods A systematic search was conducted via the PubMed, Embase, and Cochrane databases until September 2018. Randomized controlled trials (RCTs) with control receiving placebo, evaluating the effects of probiotic supplements on CKD were included.
Results A total of ten RCTs in 8 countries were selected. Conclusion Our results highlighted that probiotic supplements exerted a statistically significant effect on urea levels in non‐dialysis CKD population, while no evidence suggested that probiotics possessed meaningful impacts on the reduction of uric acid, CRP, creatinine and eGFR preservation of CKD population. This article is protected by copyright. Microbiomeâmetabolome reveals the contribution of gutâkidney axis on kidney disease | Journal of Translational Medicine | Full Text.