From the Research
Probiotics should be considered as a potential adjunctive therapy for patients undergoing dialysis, as they have been shown to improve gastrointestinal symptoms, reduce inflammation, and potentially decrease uremic toxins, according to the most recent and highest quality study 1.
Key Findings
- The study found that probiotics were beneficial in alleviating GI symptoms, with a significant mean difference of -0.52 (95% CI: -0.93, -0.1) 1.
- Prebiotics were superior in decreasing inflammatory factors such as Interleukin-6 (IL-6) and tumor-necrosis factor-α (TNF-α), while synbiotics were more effective in declining C-reactive protein (CRP) and endotoxin 1.
- Probiotics, prebiotics, and synbiotics have been shown to improve uremic toxins, inflammation, and oxidative stress in hemodialysis patients, with significant reductions in p-cresyl sulfate, endotoxins, malondialdehyde, C-reactive proteins, and interleukin 6 2.
Clinical Implications
- Patients undergoing dialysis should consult their nephrologist before starting probiotics, as their compromised immune systems may put them at higher risk for complications.
- A typical regimen might include a daily probiotic supplement containing 1-10 billion CFUs (colony-forming units), taken with meals.
- Patients should choose high-quality, refrigerated probiotics from reputable manufacturers and monitor for any adverse effects like bloating, gas, or changes in bowel habits, reporting these to their healthcare provider.
Future Directions
- Further research studies using a larger sample size with longer follow-up durations and a greater focus on clinical outcomes, including survival, are warranted to elucidate the significant clinical impact of the use of probiotics in CKD patients 3.
- The effects of probiotics on malnutrition and health-related quality of life in patients undergoing peritoneal dialysis should be further investigated, as preliminary studies have shown promising results 4.