Probiotics-Supplemented Low-Protein Diet for Microbiota Modulation in Patients with Advanced Chronic Kidney Disease (ProLowCKD): Results from a Placebo-Controlled Randomized Trial.
Study Goal
The researchers aimed to determine if combining a low-protein diet (LPD) with probiotics (Bifidobacterium longum and Lactobacillus reuteri) could reduce uremic, microbiota-derived, and proatherogenic toxins in advanced CKD patients.
Results Summary
The study found that LPD alone reduced blood urea nitrogen, total cholesterol, and triglycerides after 2 months. Probiotics supplementation further showed a trend in reducing microbiota-derived toxins and allowed a reduction in antihypertensive and diuretic medications, while the placebo group exhibited increased serum toxins.
Population
Sixty patients with advanced chronic kidney disease (CKD).
Effective Dosage
Not specified
Duration
2 months of LPD, followed by 3 months of probiotics or placebo.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low protein diet (LPD) | decrease | blood urea nitrogen | sixty patients affected by advanced CKD | 52 ± 17 vs. 46 ± 15 mg/dL | a reduction in | #1 |
low protein diet (LPD) | decrease | total cholesterol | sixty patients affected by advanced CKD | 185 ± 41 vs. 171 ± 34 mg/dL | a reduction in | #2 |
low protein diet (LPD) | decrease | triglycerides | sixty patients affected by advanced CKD | 194 ± 148 vs. 161 ± 70 mg/dL | a reduction in | #3 |
placebo | increase | total cholesterol | 27 patients in the placebo group | 169 ± 36 vs. 185 ± 40 mg/dL | showed increased serum values of | #4 |
placebo | increase | LDL cholesterol | 27 patients in the placebo group | 169 ± 36 vs. 185 ± 40 mg/dL | showed increased serum values of | #5 |
placebo | increase | lipoprotein-associated phospholipase A2 | 27 patients in the placebo group | 155.4 ± 39.3 vs. 167.5 ± 51.4 nmol/mL/min | showed increased serum values of | #6 |
placebo | increase | indoxyl-sulphate | 27 patients in the placebo group | 30.1 ± 17.6 vs. 34.5 ± 20.2 μM | showed increased serum values of | #7 |
probiotics (Bifidobacterium longum and Lactobacillus reuteri) | decrease | microbiota toxins | 24 subjects in the probiotics group | - | showed a trend in the reduction of | #8 |
probiotics (Bifidobacterium longum and Lactobacillus reuteri) | decrease | antihypertensive and diuretic medications | probiotics group | - | A reduction of | #9 |
associating probiotics to LPD | decrease | microbiota-derived and proatherogenic toxins | CKD patients | - | may have an additional beneficial effect on the control and modulation of | #10 |
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 (Bifidobacterium longum and Lactobacillus reuteri) 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, p = 0.003), total cholesterol (185 ± 41 vs. 171 ± 34 mg/dL, p = 0.001), and triglycerides (194 ± 148 vs. 161 ± 70 mg/dL, p = 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, p = 0.01), LDL cholesterol (169 ± 36 vs. 185 ± 40 mg/dL, p = 0.02), lipoprotein-associated phospholipase A2 (155.4 ± 39.3 vs. 167.5 ± 51.4 nmol/mL/min, p = 0.006), and indoxyl-sulphate (30.1 ± 17.6 vs. 34.5 ± 20.2 μM, p = 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.