Department of Nephrology, Xuanwu Hospital, Capital Medical University, Changchun Street 45#, 100053, Beijing, China.
Central Hospital of Cangzhou, Xinhua Middle Street 201#, 061001, Cangzhou, Hebei Province, China.
Int J Med Sci. 2021 Jan 1;18(3):811-820. doi: 10.7150/ijms.51484. eCollection 2021.
Resistant starch type 2 (RS2) has been documented to regulate gut microbiota and to improve the clinical outcomes of several diseases. However, whether RS2 may benefit patients with end-stage renal disease under maintenance hemodialysis (MHD) remains unknown. We conducted a systemic review and meta-analysis of randomized controlled trials (RCTs). Adult patients receiving MHD were treated with RS2 (CRD42020160332). The primary outcomes were changes of uremic toxins, and the secondary outcomes were changes of inflammatory indicators, albumin and phosphorus. After screening 65 records, five RCTs (n = 179) were included. A significant decrease of blood urea nitrogen (weighted mean difference (WMD) = -6.91, 95% CI: -11.87 to -1.95, = 0% = 0.006), serum creatinine (WMD = -1.11, 95% CI: -2.18 to -0.05, = 44%, = 0.04) and interleukin (IL)-6 in blood (standard mean difference (SMD) = -1.08, 95% CI: -1.64 to -0.53, = 35%, = 0.0001) was revealed in the RS2 group. Analyses of blood levels of uric acid, p-cresyl sulfate, indoxyl sulfate, high sensitive C-reaction protein, albumin and phosphorus yielded no significant difference. Our results suggest that RS2 may improve the residual renal function of patients under MHD and mitigate a proinflammatory response.
抗性淀粉 2 型（RS2）已被证明可调节肠道微生物群，并改善多种疾病的临床结局。然而，RS2 是否可能有益于接受维持性血液透析（MHD）的终末期肾病患者尚不清楚。我们进行了系统评价和荟萃分析的随机对照试验（RCT）。接受 MHD 的成年患者接受 RS2（CRD42020160332）治疗。主要结局是尿毒症毒素的变化，次要结局是炎症指标、白蛋白和磷的变化。经过筛选 65 条记录，纳入了五项 RCT（n = 179）。血液尿素氮（加权均数差（WMD）=-6.91，95%置信区间：-11.87 至-1.95， = 0%=0.006）、血清肌酐（WMD =-1.11，95%置信区间：-2.18 至-0.05， = 44%， = 0.04）和血液中白细胞介素（IL）-6（标准均数差（SMD）=-1.08，95%置信区间：-1.64 至-0.53， = 35%， = 0.0001）显著降低。RS2 组血液尿酸、对甲苯磺酸、吲哚硫酸、高敏 C 反应蛋白、白蛋白和磷水平的分析无显著差异。我们的结果表明，RS2 可能改善 MHD 患者的残余肾功能并减轻促炎反应。
