The effects of probiotic supplementation on renal function, inflammation, and oxidative stress in diabetic nephropathy: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (7) ◽  
pp. 1122-1131
Author(s):  
Han Wang ◽  
Dunfang Wang ◽  
Hongxin Song ◽  
Dixin Zou ◽  
Xue Feng ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Renal Function ◽  
Diabetic Nephropathy ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Probiotic Supplementation ◽  
Randomized Controlled ◽  
And Oxidative Stress

Whether supplemental probiotic therapy improves clinical outcomes in diabetic nephropathy (DN) patients remains unclear. To uncover its impacts via meta-analysis, relevant randomized controlled trials (RCTs) were searched by means of PubMed, the Cochrane Library, Embase, and Web of Science as of August 31, 2020. The effect of probiotics was reported on renal function biomarkers, oxidative stress, inflammation, and serum albumin (ALB) levels among DN patients. Random- or fixed-effects models were used to estimate pooled standardized mean differences (SMDs). Seven RCTs (456 patients) were included for final analysis. The results showed that probiotic supplementation led to a significant increase in the estimated glomerular filtration rate (eGFR) (SMD: 6.03; 95% confidence interval [CI]: 0.84–11.21; P =0.020), glutathione (GSH) levels (P < 0.001), and total antioxidant capacity (TAC) (P < 0.001). In contrast, probiotic intake significantly decreased the serum creatinine (SCr) (P = 0.020), blood urea nitrogen (BUN) (P < 0.001), malondialdehyde (MDA) (P = 0.020), and high-sensitivity C-reactive protein (hs-CRP) (P < 0.001) contents. Serum Na, K, ALB, and nitric oxide (NO) concentrations showed no significant change. Probiotics are beneficial for DN patients through improving renal function and regulating the levels of inflammation and oxidative stress biomarkers. However, probiotics do not significantly affect serum ALB, NO, Na, and K levels. These results need to be confirmed through more reliable RCTs.

scholarly journals Effects of Probiotics, Prebiotics, and Synbiotics on Uremic Toxins, Inflammation, and Oxidative Stress in Hemodialysis Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (19) ◽  
pp. 4456
Author(s):  
Thi Thuy Uyen Nguyen ◽  
Hyeong Wan Kim ◽  
Won Kim
Keyword(s):  
Oxidative Stress ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Hemodialysis Patients ◽  
Uremic Toxins ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
And Oxidative Stress

The dysbiosis of gut microbiota may cause many complications in patients with end-stage renal disease, which may be alleviated by probiotic, prebiotic, and synbiotic supplementation. The aim of this systematic review and meta-analysis was to assess the effects of these supplementations on circulatory uremic toxins, biomarkers of inflammation, and oxidative stress in hemodialysis patients. We searched the EMBASE, MEDLINE, Web of Science, and Cochrane Library databases until 8 August 2021. Randomized controlled trials evaluating adult patients receiving hemodialysis were included. The pooled results from 23 studies with 931 hemodialysis patients indicated that interventions significantly decreased the circulating levels of p-cresyl sulfate (standardized mean difference (SMD): 0.38; 95% CI: −0.61, −0.15; p = 0.001), endotoxins (SMD: −0.58; 95% CI: −0.99, −0.18; p = 0.005), malondialdehyde (SMD: −1.16; 95% CI: −1.81, −0.52; p = 0.0004), C-reactive proteins (CRP) (SMD: −0.61; 95% CI: −0.99, −0.23; p = 0.002), and interleukin 6 (SMD: −0.92; 95% CI: −1.51, −0.33; p = 0.002), and improved the total antioxidant capacity (SMD: 0.89; 95% CI: 0.49, 1.30; p < 0.0001) and glutathione (SMD: 0.40; 95% CI: 0.14, 0.66; p = 0.003) when compared to the placebo group. Our results suggest that treatment with probiotics, prebiotics, and synbiotics may help alleviate uremic toxin levels, oxidative stress, and the inflammatory status in hemodialysis patients.

scholarly journals Improvement of glucose metabolism in pregnant women through probiotic supplementation depends on gestational diabetes status: meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Karolina Łagowska ◽  
Anna M. Malinowska ◽  
Bogna Zawieja ◽  
Emilia Zawieja
Keyword(s):  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Randomized Controlled Trials ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Probiotic Supplementation ◽  
Randomized Controlled ◽  
Diabetes Status

Abstract The aim of this study was to assess the effects of probiotic and synbiotic supplementation on glucose metabolism in pregnant women using data from randomized controlled trials. Furthermore, this meta-analysis examines whether the observed effects depend on the presence or absence of gestational diabetes mellitus (GDM), and if the effect is dependent on the type of supplement used (probiotic or synbiotic). We performed a literature search of databases (Medline, Scopus, Web of Knowledge, and Cochrane Library) and identified all relevant randomized controlled trials (RCTs) published prior to May 2019. We compared the effects of probiotic supplementation with the administration of placebos in pregnant women with and without GDM. The systematic review and meta-analysis protocol were registered in the International Prospective Register of Systematic Reviews as number CRD 42019111467. 1119 study participants from 15 selected studies were included. The participants in four studies did not have GDM (being recruited to the study before week 20 of pregnancy) and the participants in the rest of the studies were diagnosed with GDM between weeks 24 and 28 of gestation. The meta-analysis showed that supplementation lowers serum glucose, insulin levels, and HOMA-IR index, but only in pregnant women with GDM. Moreover, both probiotics and synbiotics lower serum insulin level and HOMA-IR index, but the glucose lowering effect is specific only to probiotics and not synbiotics. Probiotic supplementation may improve glucose metabolism in pregnant women with GDM. There is a need for more RCT studies with larger groups to better estimate this effect.

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