Probiotic, prebiotic, synbiotic supplementation holds promise in CKD

Supplementation with probiotics, prebiotics, or synbiotics appears to improve cardiometabolic and oxidative stress parameters in patients with chronic kidney disease (CKD), according to a systematic review and meta-analysis.

Data were pooled from 14 randomized controlled trials examining the utility of probiotic, prebiotic, and synbiotic supplementation in the management of adults with CKD. Primary efficacy outcomes included measures of cardiometabolic parameters such as cholesterol and fasting blood glucose. Secondary outcomes were measures of oxidative stress (eg, malondialdehyde levels) and body mass index.

In random effects models, probiotic, prebiotic, and synbiotic supplementation conferred significant benefits to patients with CKD compared with control interventions.

Specifically, there were significant reductions seen in total cholesterol (standardized mean difference [SMD], −0.25, 95 percent confidence interval [CI], −0.46 to −0.04; I², 00.0 percent), fasting blood glucose (SMD, −0.41, 95 percent CI, −0.65 to −0.17; I², 00.0 percent), homeostatic model assessment of insulin resistance (SMD, −0.63, 95 percent CI, −0.95 to −0.30; I², 43.3 percent), insulin levels (SMD, −0.49, 95 percent CI, −0.90 to −0.08; I², 65.2 percent), high-sensitivity C-reactive protein levels (SMD, −0.52, 95 percent CI, −0.81 to −0.22; I², 52.7 percent), and malondialdehyde levels (SMD, −0.79, 95 percent CI, −1.22 to −0.37; I², 69.8 percent).

Supplementation also had a meaningful effect on the quantitative insulin sensitivity check index (SMD, 0.78, 95 percent CI, 0.51–1.05; I², 00.0 percent), total antioxidant capacity (SMD, 0.42, 95 percent CI, 0.18–0.66; I², 00.0 percent), and glutathione levels (SMD, 0.52, 95 percent CI, 0.19–0.86; I², 37.0 percent).