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Open AccessReview

Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis

CNR-Institute of Clinical Physiology, Reggio Calabria 89124, Italy
Nephrology and Dialysis Unit, “Pugliese-Ciaccio” Hospital of Catanzaro, Catanzaro 88100, Italy
Author to whom correspondence should be addressed.
Nutrients 2018, 10(9), 1224;
Received: 15 June 2018 / Revised: 28 August 2018 / Accepted: 29 August 2018 / Published: 4 September 2018
Intestinal dysbiosis is highly pervasive among chronic kidney disease (CKD) patients and may play a key role in disease progression and complications. We performed a systematic review and meta-analysis to evaluate effects of biotic supplements on a large series of outcomes in renal patients. Ovid-MEDLINE, PubMed and CENTRAL databases were searched for randomized controlled trials (RCTs) comparing any biotic (pre-, pro- or synbiotics) to standard therapy or placebo. Primary endpoints were change in renal function and cardiovascular events; secondary endpoints were change in proteinuria/albuminuria, inflammation, uremic toxins, quality of life and nutritional status. Seventeen eligible studies (701 participants) were reviewed. Biotics treatment did not modify estimated glomerular filtration rate (eGFR) (mean difference (MD) 0.34 mL/min/1.73 m2; 95% CI −0.19, 0.86), serum creatinine (MD −0.13 mg/dL; 95% confidence interval (CI) −0.32, 0.07), C-reactive protein (MD 0.75 mg/dL; 95% CI −1.54, 3.03) and urea (standardized MD (SMD) −0.02; 95% CI −0.25, 0.20) as compared to control. Outcome data on the other endpoints of interest were lacking, sparse or in an unsuitable format to be analyzed collectively. According to the currently available evidence, there is no conclusive rationale for recommending biotic supplements for improving outcomes in renal patients. Large-scale, well-designed and adequately powered studies focusing on hard rather than surrogate outcomes are still awaited. View Full-Text
Keywords: chronic kidney disease; end-stage kidney disease; gut microbiota; prebiotics; probiotics; synbiotics chronic kidney disease; end-stage kidney disease; gut microbiota; prebiotics; probiotics; synbiotics
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MDPI and ACS Style

Pisano, A.; D’Arrigo, G.; Coppolino, G.; Bolignano, D. Biotic Supplements for Renal Patients: A Systematic Review and Meta-Analysis. Nutrients 2018, 10, 1224.

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