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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.
J Clin Med. 2021 Sep 28; 10(19)JC

Abstract

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.

Authors+Show Affiliations

Department of Histology, Embryology, Pathology and Forensic Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue 52000, Vietnam. Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54896, Korea.Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54896, Korea.Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju 54896, Korea. Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

34640474

Citation

Nguyen, Thi Thuy Uyen, et al. "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." Journal of Clinical Medicine, vol. 10, no. 19, 2021.
Nguyen TTU, Kim HW, Kim W. 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. J Clin Med. 2021;10(19).
Nguyen, T. T. U., Kim, H. W., & Kim, W. (2021). 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. Journal of Clinical Medicine, 10(19). https://doi.org/10.3390/jcm10194456
Nguyen TTU, Kim HW, Kim W. 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. J Clin Med. 2021 Sep 28;10(19) PubMed PMID: 34640474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Nguyen,Thi Thuy Uyen, AU - Kim,Hyeong Wan, AU - Kim,Won, Y1 - 2021/09/28/ PY - 2021/08/15/received PY - 2021/09/24/revised PY - 2021/09/24/accepted PY - 2021/10/13/entrez PY - 2021/10/14/pubmed PY - 2021/10/14/medline KW - chronic kidney disease KW - hemodialysis KW - prebiotic KW - probiotic KW - synbiotic JF - Journal of clinical medicine JO - J Clin Med VL - 10 IS - 19 N2 - 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. SN - 2077-0383 UR - https://www.unboundmedicine.com/medline/citation/34640474/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_ DB - PRIME DP - Unbound Medicine ER -
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