Kidney Research Laboratory, Division of Nephrology, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cardiology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Nephrology (Carlton). 2019 Nov;24(11):1122-1130. doi: 10.1111/nep.13549. Epub 2019 Apr 30.
Chronic kidney disease (CKD) is a worldwide public health problem. Although accumulated data suggested that probiotic supplements played roles in CKD, the results remained controversial. Here, we performed a meta-analysis to assess the effects of probiotic supplements on the CKD progression.
A systematic search was conducted through the PubMed, Embase and Cochrane databases until September 2018. Randomized controlled trials with control receiving placebo, evaluating the effects of probiotic supplements on CKD were included.
A total of 10 randomized controlled trials in 8 countries were selected. In the meta-analysis, urea level was significantly reduced in probiotics-administrated non-dialysis patients (mean differences (MD) = -30.01; 95% confidence interval (CI) = [-56.78, -3.25]; P = 0.03) while no significant change was found in the dialysis patients receiving probiotics (MD = 0.1; 95% CI = [-9.28, 9.48]; P = 0.98). Probiotic supplements also exhibited no effect on uric acid (MD = -0.43; 95% CI = [-1.19, 0.33]; P = 0.27), C-reactive protein (MD = -0.48; 95% CI = [-1.29, 0.33]; P = 0.24), creatinine (MD = -0.18; 95% CI = [-0.82, 0.47]; P = 0.59), and estimated glomerular filtration rate (MD = 2.10; 95% CI = [-1.31, 5.52]; P = 0.23) of CKD patients.
Our results highlighted that probiotic supplements exerted a statistically significant effect on urea levels in non-dialysis CKD population, while no evidence suggested that probiotics possessed meaningful impacts on the reduction of uric acid, C-reactive protein, creatinine and estimated glomerular filtration rate preservation of CKD population.
慢性肾脏病（CKD）是一个全球性的公共卫生问题。尽管有大量数据表明益生菌补充剂在 CKD 中发挥作用，但结果仍存在争议。在这里，我们进行了一项荟萃分析，以评估益生菌补充剂对 CKD 进展的影响。
通过 PubMed、Embase 和 Cochrane 数据库进行系统检索，检索时间截至 2018 年 9 月。纳入了接受安慰剂对照、评估益生菌补充剂对 CKD 影响的随机对照试验。
共纳入 8 个国家的 10 项随机对照试验。在荟萃分析中，非透析患者接受益生菌治疗后尿素水平显著降低（平均差异（MD）=-30.01；95%置信区间（CI）=-56.78，-3.25；P=0.03），而接受益生菌治疗的透析患者尿素水平无显著变化（MD=0.1；95%CI=-9.28，9.48；P=0.98）。益生菌补充剂对尿酸（MD=-0.43；95%CI=-1.19，0.33；P=0.27）、C 反应蛋白（MD=-0.48；95%CI=-1.29，0.33；P=0.24）、肌酐（MD=-0.18；95%CI=-0.82，0.47；P=0.59）和估计肾小球滤过率（MD=2.10；95%CI=-1.31，5.52；P=0.23）也没有影响。
我们的结果强调，益生菌补充剂对非透析 CKD 患者的尿素水平有统计学意义的影响，而没有证据表明益生菌对降低尿酸、C 反应蛋白、肌酐和保护 CKD 患者的估计肾小球滤过率有明显作用。
