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Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis.
Nutrients. 2018 Sep 04; 10(9)N

Abstract

Intestinal dysbiosis is highly pervasive among chronic kidney disease (CKD) patients and may play a key role in disease progression and complications. We performed a systematic review and meta-analysis to evaluate effects of biotic supplements on a large series of outcomes in renal patients. Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing any biotic (pre-, pro- or synbiotics) to standard therapy or placebo. Primary endpoints were change in renal function and cardiovascular events; secondary endpoints were change in proteinuria/albuminuria, inflammation, uremic toxins, quality of life and nutritional status. Seventeen eligible studies (701 participants) were reviewed. Biotics treatment did not modify estimated glomerular filtration rate (eGFR) (mean difference (MD) 0.34 mL/min/1.73 m²; 95% CI -0.19, 0.86), serum creatinine (MD -0.13 mg/dL; 95% confidence interval (CI) -0.32, 0.07), C-reactive protein (MD 0.75 mg/dL; 95% CI -1.54, 3.03) and urea (standardized MD (SMD) -0.02; 95% CI -0.25, 0.20) as compared to control. Outcome data on the other endpoints of interest were lacking, sparse or in an unsuitable format to be analyzed collectively. According to the currently available evidence, there is no conclusive rationale for recommending biotic supplements for improving outcomes in renal patients. Large-scale, well-designed and adequately powered studies focusing on hard rather than surrogate outcomes are still awaited.

Authors+Show Affiliations

CNR-Institute of Clinical Physiology, Reggio Calabria 89124, Italy. pisanoanna@hotmail.it.CNR-Institute of Clinical Physiology, Reggio Calabria 89124, Italy. g.darrigostat@tin.it.Nephrology and Dialysis Unit, "Pugliese-Ciaccio" Hospital of Catanzaro, Catanzaro 88100, Italy. gcoppolino@hotmail.it.CNR-Institute of Clinical Physiology, Reggio Calabria 89124, Italy. davide.bolignano@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30181461

Citation

Pisano, Anna, et al. "Biotic Supplements for Renal Patients: a Systematic Review and Meta-Analysis." Nutrients, vol. 10, no. 9, 2018.
Pisano A, D'Arrigo G, Coppolino G, et al. Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(9).
Pisano, A., D'Arrigo, G., Coppolino, G., & Bolignano, D. (2018). Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis. Nutrients, 10(9). https://doi.org/10.3390/nu10091224
Pisano A, et al. Biotic Supplements for Renal Patients: a Systematic Review and Meta-Analysis. Nutrients. 2018 Sep 4;10(9) PubMed PMID: 30181461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis. AU - Pisano,Anna, AU - D'Arrigo,Graziella, AU - Coppolino,Giuseppe, AU - Bolignano,Davide, Y1 - 2018/09/04/ PY - 2018/06/15/received PY - 2018/08/28/revised PY - 2018/08/28/accepted PY - 2018/9/6/entrez PY - 2018/9/6/pubmed PY - 2019/1/22/medline KW - chronic kidney disease KW - end-stage kidney disease KW - gut microbiota KW - prebiotics KW - probiotics KW - synbiotics JF - Nutrients JO - Nutrients VL - 10 IS - 9 N2 - Intestinal dysbiosis is highly pervasive among chronic kidney disease (CKD) patients and may play a key role in disease progression and complications. We performed a systematic review and meta-analysis to evaluate effects of biotic supplements on a large series of outcomes in renal patients. Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing any biotic (pre-, pro- or synbiotics) to standard therapy or placebo. Primary endpoints were change in renal function and cardiovascular events; secondary endpoints were change in proteinuria/albuminuria, inflammation, uremic toxins, quality of life and nutritional status. Seventeen eligible studies (701 participants) were reviewed. Biotics treatment did not modify estimated glomerular filtration rate (eGFR) (mean difference (MD) 0.34 mL/min/1.73 m²; 95% CI -0.19, 0.86), serum creatinine (MD -0.13 mg/dL; 95% confidence interval (CI) -0.32, 0.07), C-reactive protein (MD 0.75 mg/dL; 95% CI -1.54, 3.03) and urea (standardized MD (SMD) -0.02; 95% CI -0.25, 0.20) as compared to control. Outcome data on the other endpoints of interest were lacking, sparse or in an unsuitable format to be analyzed collectively. According to the currently available evidence, there is no conclusive rationale for recommending biotic supplements for improving outcomes in renal patients. Large-scale, well-designed and adequately powered studies focusing on hard rather than surrogate outcomes are still awaited. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/30181461/Biotic_Supplements_for_Renal_Patients:_A_Systematic_Review_and_Meta_Analysis_ L2 - https://www.mdpi.com/resolver?pii=nu10091224 DB - PRIME DP - Unbound Medicine ER -