Impact of Probiotic Supplementation on Chronic Kidney Disease: A Comparative Study of Dialysis and Nondialysis Patients.

BACKGROUND

In chronic kidney disease (CKD) patients, the long-term effects of probiotic use are unknown.

AIM: This study aimed to evaluate the effectiveness of long-term probiotics supplementation on kidney function, inflammatory markers, and metabolic parameters in CKD patients with or without hemodialysis (HD).

METHODS

This retrospective study included two groups: 70 CKD patients on HD and 124 stage IIIb-V CKD patients not on HD, with half of these patients in both the groups receiving probiotics, in addition to standard of care (SOC, n = 35 and n = 62, respectively), whereas another half received only SOC (n = 35 and n = 62, respectively). Kidney function (serum creatinine, blood urea nitrogen, and serum uric acid), systemic inflammation (high-sensitivity C-reactive protein [hs-CRP]), metabolic parameters (serum calcium, serum phosphate, and intact parathyroid hormone), and nutritional state (total iron binding capacity and serum albumin) were evaluated at 3-, 6-, and 12-months of treatment.

RESULTS

At 12 months, the non-HD group that received SOC + probiotics had a significant improvement in all the parameters evaluated (all P < 0.0001), whereas those that received only SOC had a significant reduction in serum phosphate, serum uric acid, and hs-CRP (all P < 0.05). In the HD group, over 12 months, there was a significant reduction in only hs-CRP (P = 0.034) in the SOC + Probiotics subgroup. The non-HD group had a significantly greater change in all the parameters assessed relative to HD group (all P < 0.05), except serum calcium (P = 0.408).

CONCLUSIONS

Long-term probiotic use leads to significant improvement among non-HD CKD patients relative to CKD patients on HD.