de Araújo Érica Maria Rodrigues, Meneses Gdayllon Cavalcante, Carioca Antônio Augusto Ferreira, Martins Alice Maria Costa, Daher Elizabeth De Francesco, Silva Junior Geraldo Bezerra
Universidade de Fortaleza, Programa de Pós-Graduação em Ciências Médicas, Fortaleza, CE, Brazil.
Universidade de Fortaleza, Curso de Nutrição e Programa de Pós-Graduação em Saúde Coletiva, Fortaleza, CE, Brazil.
J Bras Nefrol. 2023 Apr-Jun;45(2):152-161. doi: 10.1590/2175-8239-JBN-2022-0021en.
Supplementation with probiotics for patients with chronic kidney disease (CKD) may be associated with decreased systemic inflammation.
To assess the impact of oral supplementation with probiotics for patients with CKD on hemodialysis.
This double-blind randomized clinical trial included 70 patients on hemodialysis; 32 were given oral supplementation with probiotics and 38 were in the placebo group. Blood samples were collected at the start of the study and patients were given oral supplementation with probiotics or placebo for three months. The probiotic supplement comprised four strains of encapsulated Gram-positive bacteria: Lactobacillus Plantarum A87, Lactobacillus rhamnosus, Bifidobacterium bifidum A218 and Bifidobacterium longum A101. Patients were given one capsule per day for 3 months. Blood samples were taken throughout the study to check for inflammatory biomarkers. Non-traditional biomarkers Syndecan-1, IFN-y, NGAL, and cystatin C were measured using an ELISA kit, along with biochemical parameters CRP, calcium, phosphorus, potassium, PTH, GPT, hematocrit, hemoglobin, glucose, and urea.
Patients given supplementation with probiotics had significant decreases in serum levels of syndecan-1 (239 ± 113 to 184 ± 106 ng/mL, p = 0.005); blood glucose levels also decreased significantly (162 ± 112 to 146 ± 74 mg/dL, p = 0.02).
Administration of probiotics to patients with advanced CKD was associated with decreases in syndecan-1 and blood glucose levels, indicating potential improvements in metabolism and decreased systemic inflammation.
慢性肾脏病（CKD）患者补充益生菌可能与全身炎症反应减轻有关。
评估口服补充益生菌对CKD患者血液透析的影响。
这项双盲随机临床试验纳入了70例接受血液透析的患者；32例给予口服益生菌补充剂，38例为安慰剂组。在研究开始时采集血样，患者口服益生菌或安慰剂三个月。益生菌补充剂包含四株封装的革兰氏阳性菌：植物乳杆菌A87、鼠李糖乳杆菌、两歧双歧杆菌A218和长双歧杆菌A101。患者每天服用一粒胶囊，持续3个月。在整个研究过程中采集血样以检测炎症生物标志物。使用酶联免疫吸附测定试剂盒测量非传统生物标志物Syndecan-1、干扰素-γ、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）和胱抑素C，以及生化参数C反应蛋白（CRP）、钙、磷、钾、甲状旁腺激素（PTH）、谷丙转氨酶（GPT）、血细胞比容、血红蛋白、葡萄糖和尿素。
补充益生菌的患者血清Syndecan-1水平显著降低（从239±113降至184±106 ng/mL，p = 0.005）；血糖水平也显著降低（从162±112降至146±74 mg/dL，p = 0.02）。
对晚期CKD患者施用益生菌与Syndecan-1和血糖水平降低有关，表明代谢可能得到改善且全身炎症反应减轻。
