Nephrology and Dialysis Unit, Maggiore della Carità University Hospital, 28100 Novara, Italy.
Dietetic and Clinical Nutrition, Maggiore della Carità University Hospital, 28100 Novara, Italy.
Nutrients. 2022 Apr 14;14(8):1637. doi: 10.3390/nu14081637.
The probiotics-supplemented low-protein diet in chronic kidney disease (ProLowCKD) was a single-centre, double-blind, placebo-controlled, randomised trial that was conducted to investigate whether the association between a low protein diet (LPD) and a new formulation of probiotics ( and ) was effective at reducing traditional uremic, microbiota-derived, and proatherogenic toxins in sixty patients affected by advanced CKD. After 2 months of a LPD-a reduction in blood urea nitrogen (52 ± 17 vs. 46 ± 15 mg/dL, = 0.003), total cholesterol (185 ± 41 vs. 171 ± 34 mg/dL, = 0.001), and triglycerides (194 ± 148 vs. 161 ± 70 mg/dL, = 0.03) was observed; 57 subjects were then randomized to receive probiotics or a placebo for the subsequent 3 months. A total of 27 patients in the placebo group showed increased serum values of total cholesterol (169 ± 36 vs. 185 ± 40 mg/dL, = 0.01), LDL cholesterol (169 ± 36 vs. 185 ± 40 mg/dL, = 0.02), lipoprotein-associated phospholipase A (155.4 ± 39.3 vs. 167.5 ± 51.4 nmol/mL/min, = 0.006), and indoxyl-sulphate (30.1 ± 17.6 vs. 34.5 ± 20.2 μM, = 0.026), while the 24 subjects in the probiotics group showed a trend in the reduction of microbiota toxins. A reduction of antihypertensive and diuretic medications was possible in the probiotics group. This study shows that associating probiotics to LPD may have an additional beneficial effect on the control and modulation of microbiota-derived and proatherogenic toxins in CKD patients.
该益生菌补充低蛋白饮食在慢性肾脏病（ProLowCKD）是一个单中心、双盲、安慰剂对照、随机试验，旨在探讨低蛋白饮食（LPD）与新配方益生菌（和）之间的关联是否能有效降低 60 例晚期慢性肾脏病患者的传统尿毒症、微生物群衍生和促动脉粥样硬化毒素。在接受 LPD 治疗 2 个月后，血尿素氮（52 ± 17 与 46 ± 15mg/dL，= 0.003）、总胆固醇（185 ± 41 与 171 ± 34mg/dL，= 0.001）和甘油三酯（194 ± 148 与 161 ± 70mg/dL，= 0.03）均有下降；随后，57 名受试者被随机分为益生菌组或安慰剂组，继续接受接下来 3 个月的治疗。安慰剂组共有 27 名患者的血清总胆固醇（169 ± 36 与 185 ± 40mg/dL，= 0.01）、LDL 胆固醇（169 ± 36 与 185 ± 40mg/dL，= 0.02）、脂蛋白相关磷脂酶 A（155.4 ± 39.3 与 167.5 ± 51.4nmol/mL/min，= 0.006）和吲哚硫酸（30.1 ± 17.6 与 34.5 ± 20.2μM，= 0.026）水平升高，而益生菌组的 24 名患者的微生物群毒素呈下降趋势。益生菌组可能减少了降压和利尿剂的使用。本研究表明，在 LPD 中添加益生菌可能对慢性肾脏病患者的微生物群衍生和促动脉粥样硬化毒素的控制和调节有额外的益处。
