Tags

Type your tag names separated by a space and hit enter

Effects of Microbiota-Driven Therapy on Circulating Indoxyl Sulfate and P-Cresyl Sulfate in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Adv Nutr. 2022 Aug 01; 13(4):1267-1278.AN

Abstract

Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), protein-bound uremic toxins, exacerbate the deterioration of renal function and increase the risk of cardiovascular events in chronic kidney disease (CKD) patients. The effects of microbiota-driven therapy (probiotics, prebiotics, or synbiotics) on decreasing circulating IS and PCS concentrations are controversial; thus, we performed the present systematic review and meta-analysis to assess the effects of microbiota-driven therapy on circulating IS and PCS concentrations in CKD patients. PubMed, EMBASE, and Cochrane Library databases were systematically searched from inception to 22 July, 2021, and randomized controlled trials (RCTs) investigating the effects of microbiota-driven therapy on circulating IS and PCS concentrations in CKD patients were included. In all, 14 RCTs with 513 participants were eligible for the meta-analysis. The effects of microbiota-driven therapy on the circulating IS and PCS concentrations were evaluated with weighted mean differences (WMDs) measured by a fixed-effects model or a random-effects model. Compared with placebo, microbiota-driven therapy had no statistically significant effect on the circulating IS concentration (WMD: -1.64 mg/L; 95% CI: -3.46, 0.18 mg/L; P = 0.077) but it decreased the circulating PCS concentration (WMD: -2.42 mg/L; 95% CI: -3.81, -1.04 mg/L; P = 0.001). In the subgroup analyses, prebiotic (n = 6) and synbiotic (n = 3) supplementation significantly decreased the circulating PCS concentration, whereas probiotic (n = 3) supplementation did not. Meta-regression showed that the effects of microbiota-driven therapy were not associated with the supplementation time or the year of publication. Moreover, there was no significant evidence of publication bias. This review found that microbiota-driven therapy decreased the circulating PCS concentration in CKD patients. Additional large, well-designed RCTs with improved methodology and reporting are necessary to assess the effects of microbiota-driven therapy on circulating IS and PCS concentrations in the long term. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42021269146.

Authors+Show Affiliations

Xi yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. Peking University Traditional Chinese Medicine Clinical Medical School (Xi yuan), Beijing, China. National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China.Xi yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.Xi yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China.Xi yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. Peking University Traditional Chinese Medicine Clinical Medical School (Xi yuan), Beijing, China. National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China.Xi yuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China. National Medical Products Administration Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Beijing, China.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

34905018

Citation

Chen, Li, et al. "Effects of Microbiota-Driven Therapy On Circulating Indoxyl Sulfate and P-Cresyl Sulfate in Patients With Chronic Kidney Disease: a Systematic Review and Meta-Analysis of Randomized Controlled Trials." Advances in Nutrition (Bethesda, Md.), vol. 13, no. 4, 2022, pp. 1267-1278.
Chen L, Shi J, Ma X, et al. Effects of Microbiota-Driven Therapy on Circulating Indoxyl Sulfate and P-Cresyl Sulfate in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2022;13(4):1267-1278.
Chen, L., Shi, J., Ma, X., Shi, D., & Qu, H. (2022). Effects of Microbiota-Driven Therapy on Circulating Indoxyl Sulfate and P-Cresyl Sulfate in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Advances in Nutrition (Bethesda, Md.), 13(4), 1267-1278. https://doi.org/10.1093/advances/nmab149
Chen L, et al. Effects of Microbiota-Driven Therapy On Circulating Indoxyl Sulfate and P-Cresyl Sulfate in Patients With Chronic Kidney Disease: a Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2022 Aug 1;13(4):1267-1278. PubMed PMID: 34905018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Microbiota-Driven Therapy on Circulating Indoxyl Sulfate and P-Cresyl Sulfate in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. AU - Chen,Li, AU - Shi,Junhe, AU - Ma,Xiaojuan, AU - Shi,Dazhuo, AU - Qu,Hua, PY - 2021/9/13/received PY - 2021/11/3/revised PY - 2021/12/2/accepted PY - 2022/12/14/pmc-release PY - 2021/12/15/pubmed PY - 2022/8/3/medline PY - 2021/12/14/entrez KW - chronic kidney disease KW - indoxyl sulfate KW - meta-analysis KW - microbiota-driven therapy KW - p-cresyl sulfate SP - 1267 EP - 1278 JF - Advances in nutrition (Bethesda, Md.) JO - Adv Nutr VL - 13 IS - 4 N2 - Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), protein-bound uremic toxins, exacerbate the deterioration of renal function and increase the risk of cardiovascular events in chronic kidney disease (CKD) patients. The effects of microbiota-driven therapy (probiotics, prebiotics, or synbiotics) on decreasing circulating IS and PCS concentrations are controversial; thus, we performed the present systematic review and meta-analysis to assess the effects of microbiota-driven therapy on circulating IS and PCS concentrations in CKD patients. PubMed, EMBASE, and Cochrane Library databases were systematically searched from inception to 22 July, 2021, and randomized controlled trials (RCTs) investigating the effects of microbiota-driven therapy on circulating IS and PCS concentrations in CKD patients were included. In all, 14 RCTs with 513 participants were eligible for the meta-analysis. The effects of microbiota-driven therapy on the circulating IS and PCS concentrations were evaluated with weighted mean differences (WMDs) measured by a fixed-effects model or a random-effects model. Compared with placebo, microbiota-driven therapy had no statistically significant effect on the circulating IS concentration (WMD: -1.64 mg/L; 95% CI: -3.46, 0.18 mg/L; P = 0.077) but it decreased the circulating PCS concentration (WMD: -2.42 mg/L; 95% CI: -3.81, -1.04 mg/L; P = 0.001). In the subgroup analyses, prebiotic (n = 6) and synbiotic (n = 3) supplementation significantly decreased the circulating PCS concentration, whereas probiotic (n = 3) supplementation did not. Meta-regression showed that the effects of microbiota-driven therapy were not associated with the supplementation time or the year of publication. Moreover, there was no significant evidence of publication bias. This review found that microbiota-driven therapy decreased the circulating PCS concentration in CKD patients. Additional large, well-designed RCTs with improved methodology and reporting are necessary to assess the effects of microbiota-driven therapy on circulating IS and PCS concentrations in the long term. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42021269146. SN - 2156-5376 UR - https://www.unboundmedicine.com/medline/citation/34905018/Effects_of_Microbiota_driven_Therapy_on_Circulating_Indoxyl_Sulfate_and_P_cresyl_Sulfate_in_Patients_with_Chronic_Kidney_Disease:_A_Systematic_Review_and_Meta_Analysis_of_Randomized_Controlled_Trials_ DB - PRIME DP - Unbound Medicine ER -