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Probiotic Supplementation in Chronic Kidney Disease: A Double-blind, Randomized, Placebo-controlled Trial.
- Source :
-
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation [J Ren Nutr] 2018 Jan; Vol. 28 (1), pp. 28-36. Date of Electronic Publication: 2017 Sep 06. - Publication Year :
- 2018
-
Abstract
- Objective: The objective of the study was to evaluate the effects of probiotic supplementation on the gut microbiota profile and inflammatory markers in chronic kidney disease patients undergoing maintenance hemodialysis (HD).<br />Design and Methods: This was a randomized, double-blind, placebo-controlled study. Forty-six HD patients were assigned to receive 1 of 2 treatments: probiotic (n = 23; Streptococcus thermophilus, Lactobacillus acidophilus e Bifidobacterialongum, 90 billion colony-forming units per day) or placebo (n = 23) daily for 3 months. Blood and feces were collected at baseline and after intervention. The inflammatory markers (C-reactive protein and interleukin-6) were analyzed by immunoenzymatic assay (enzyme-linked immunosorbent assay). Uremic toxins plasma levels (indoxyl sulfate, p-cresyl sulfate, and indole-3-acetic acid) were obtained by Reversed-Phase High-Performance Liquid Chromatography. Routine laboratory parameters were measured by standard techniques. Fecal pH was measured by the colorimetric method, and the gut microbiota profile was assessed by Denaturing Gradient Gel Electrophoresis analysis.<br />Results: Sixteen patients remained in the probiotic group (11 men, 53.6 ± 11.0 year old, 25.3 ± 4.6 kg/m <superscript>2</superscript> ) and 17 in the placebo group (10 men, 50.3 ± 8.5 year old, 25.2 ± 5.7 kg/m <superscript>2</superscript> ). After probiotic supplementation there was a significant increase in serum urea (from 149.6 ± 34.2 mg/dL to 172.6 ± 45.0 mg/dL, P = .02), potassium (from 4.4 ± 0.4 mmol/L to 4.8 ± 0.4 mmol/L, P = .02), and indoxyl sulfate (from 31.2 ± 15.9 to 36.5 ± 15.0 mg/dL, P = .02). The fecal pH was reduced from 7.2 ± 0.8 to 6.5 ± 0.5 (P = .01). These parameters did not change significantly in placebo group. Changes in the percentage delta (Δ) between groups were exhibited with no statistical differences observed. The inflammatory markers and gut profile were not altered by supplementation.<br />Conclusions: Aprobiotic supplementation failed to reduce uremic toxins and inflammatory markers. Therefore, probiotic therapy should be chosen with caution in HD patients. Further studies addressing probiotic therapy in chronic kidney disease patients are needed.<br /> (Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Bifidobacterium
Biomarkers blood
Blood Glucose metabolism
Body Mass Index
C-Reactive Protein metabolism
Cresols blood
Double-Blind Method
Feces chemistry
Feces microbiology
Female
Gastrointestinal Microbiome
Humans
Hydrogen-Ion Concentration
Indican blood
Indoleacetic Acids blood
Interleukin-6 blood
Lactobacillus acidophilus
Male
Middle Aged
Nutrition Assessment
Renal Insufficiency, Chronic microbiology
Streptococcus thermophilus
Sulfuric Acid Esters blood
Waist Circumference
Probiotics administration & dosage
Renal Insufficiency, Chronic therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8503
- Volume :
- 28
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
- Publication Type :
- Academic Journal
- Accession number :
- 28888762
- Full Text :
- https://doi.org/10.1053/j.jrn.2017.06.010