Department of Nephrology, Jianli People's Hospital, Jianli, China.
Department of Emergency, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China.
Ren Fail. 2024 Dec;46(2):2416609. doi: 10.1080/0886022X.2024.2416609. Epub 2024 Oct 24.
Recent studies have shown that consumption of resistant starch (RS) has beneficial effects on the gut microbiota and immune function in patients with chronic kidney disease (CKD). The objective of this study was to evaluate the effects of RS on inflammation, uremic toxins, and renal function in patients with CKD through a systematic review and meta-analysis.
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-2020. We included randomized controlled trials comparing RS supplementation to placebo. The National Library of Medicine (PubMed), Excerpta Medica Database (Embase), Cochrane Library, Web of Science, China National Knowledge Internet (CNKI) databases, and two gray literature sources - Baidu and Research Gate, were used for search, up to 28 August 2024. There was no limitation on publication date, but only manuscripts published in English and Chinese were included.
A total of 645 articles were retrieved. Ten articles met the inclusion criteria, and a total of 355 subjects were included. The analysis revealed that RS dietary intervention can significantly reduce indoxyl sulfate (IS) levels (SMD: -0.37, 95% confidence interval (CI): -0.70 to -0.04, = .03) and blood urea nitrogen (BUN) levels (SMD: -0.30, 95% CI: -0.57 to -0.02, = .03). There were no significant differences in the levels of interleukin-6 (IL-6), p-cresyl sulfate (p-CS), albumin, phosphorus, or tumor necrosis factor-α.
The RS diet has potential beneficial effects on uremic toxin levels and renal function indices in patients with CKD. RS supplementation can reduce uremic toxin levels and improve renal function but does not reduce the inflammatory response in patients with CKD. Nevertheless, results should be cautiously interpreted, because of the limited sample size and different treatment dosages. Further research is necessary to corroborate the beneficial effects of RS2 supplementation in this population.
最近的研究表明，抗性淀粉（RS）的摄入对慢性肾脏病（CKD）患者的肠道微生物群和免疫功能有有益影响。本研究旨在通过系统评价和荟萃分析评估 RS 对 CKD 患者炎症、尿毒症毒素和肾功能的影响。
本系统评价按照 PRISMA-2020 进行。我们纳入了比较 RS 补充剂与安慰剂的随机对照试验。使用美国国立医学图书馆（PubMed）、医学文摘数据库（Embase）、考科兰图书馆、Web of Science、中国国家知识基础设施（CNKI）数据库以及两个灰色文献来源——百度和 Research Gate 进行搜索，截至 2024 年 8 月 28 日。没有对出版日期进行限制，但仅纳入英文和中文发表的手稿。
共检索到 645 篇文章。10 篇文章符合纳入标准，共纳入 355 例患者。分析显示，RS 饮食干预可显著降低吲哚硫酸酯（IS）水平（SMD：-0.37，95%置信区间（CI）：-0.70 至 -0.04，=0.03）和血尿素氮（BUN）水平（SMD：-0.30，95%CI：-0.57 至 -0.02，=0.03）。白细胞介素-6（IL-6）、对甲酚硫酸盐（p-CS）、白蛋白、磷或肿瘤坏死因子-α水平无显著差异。
RS 饮食对 CKD 患者尿毒症毒素水平和肾功能指标有潜在的有益影响。RS 补充剂可降低尿毒症毒素水平，改善肾功能，但不能降低 CKD 患者的炎症反应。然而，由于样本量有限和不同的治疗剂量，结果应谨慎解释。需要进一步的研究来证实 RS2 补充剂在这一人群中的有益作用。
