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补充益生元、益生菌和合生菌对肾功能血液参数的影响:临床试验的系统评价和荟萃分析。

The effects of prebiotic, probiotic, and synbiotic supplementation on blood parameters of renal function: A systematic review and meta-analysis of clinical trials.

机构信息

Department of Nutrition and Dietetics, University Putra Malaysia, Kuala Lumpur, Malaysia.

Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Nutrition. 2018 Jul-Aug;51-52:104-113. doi: 10.1016/j.nut.2018.01.007. Epub 2018 Feb 6.


DOI:10.1016/j.nut.2018.01.007
PMID:29626749
Abstract

OBJECTIVES: Recent studies have demonstrated promising results regarding possible improvements in renal function after prebiotic, probiotic, and synbiotic supplementation. The aim of this review was to demonstrate whether such supplementation will improve renal profile indexes including glomerular filtration rate (GFR), creatinine, blood urea nitrogen (BUN), uric acid (UA), and urea. METHOD: The meta-analysis included all studies that examined the effect of prebiotic, probiotic, and synbiotic supplements on one or more renal function parameters and had a control group. We searched July 1967 through to March 2016 MEDLINE, Scopus, and Google Scholar databases. RESULTS: Of 437 studies, 13 were eligible for inclusion in the meta-analysis. GFR levels tended to be reduced; whereas creatinine levels increased in the intervention group compared with the placebo group, both in a non-significant manner. The pooled effect on BUN demonstrated a significant decline compared with the placebo group (MD, -1.72 mmol/L; 95% confidence interval [CI], -2.93 to -0.51; P = 0.005). Urea significantly decreased after intervention (-0.46 mmol/L; 95% CI, -0.60 to -0.32; P <0.0001). The UA levels significantly increased in the intervention group compared with the placebo group (12.28 µmol/L; 95% CI, 0.85-23.71; P = 0.035). CONCLUSION: This study showed a significant increase in UA and a decrease in urea and BUN. The use of prebiotic, probiotic, and synbiotic supplements among those with compromised renal function or those at risk for renal failure should be limited until large-scale, well-designed randomized controlled trials prove the safety and efficacy of these supplements in improving renal function.

摘要

目的:最近的研究表明,益生菌、益生元和合生剂补充剂可能改善肾功能,具有令人鼓舞的结果。本综述的目的是证明这种补充剂是否会改善包括肾小球滤过率(GFR)、肌酐、血尿素氮(BUN)、尿酸(UA)和尿素在内的肾脏指标。

方法:荟萃分析包括所有研究,这些研究检查了益生元、益生菌和合生剂补充剂对一个或多个肾功能参数的影响,并设有对照组。我们检索了 1967 年 7 月至 2016 年 3 月期间的 MEDLINE、Scopus 和 Google Scholar 数据库。

结果:在 437 项研究中,有 13 项符合纳入荟萃分析的标准。与安慰剂组相比,GFR 水平有降低的趋势,而肌酐水平升高,但无统计学意义。与安慰剂组相比,BUN 的汇总效应显示出显著下降(MD,-1.72mmol/L;95%置信区间[CI],-2.93 至-0.51;P=0.005)。干预后尿素显著下降(-0.46mmol/L;95%CI,-0.60 至-0.32;P<0.0001)。与安慰剂组相比,干预组的 UA 水平显著升高(12.28µmol/L;95%CI,0.85-23.71;P=0.035)。

结论:本研究表明 UA 显著升高,尿素和 BUN 降低。对于肾功能受损或有肾衰竭风险的患者,应限制使用益生菌、益生元和合生剂补充剂,直到大规模、精心设计的随机对照试验证明这些补充剂在改善肾功能方面的安全性和有效性。

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[2]
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[3]
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[4]
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[5]
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[7]
Renal Health Improvement in Diabetes through Microbiome Modulation of the Gut-Kidney Axis with Biotics: A Systematic and Narrative Review of Randomized Controlled Trials.

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[8]
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[9]
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[10]
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