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Probiotics may benefit patients with CKD
Certain studies have indicated that consumption of probiotics may improve gastrointestinal function and slow the progression of chronic kidney disease.
“According to the Office of Disease Prevention and Health Promotion, Medicare spends approximately 25% of its money on treatment for patients with chronic kidney disease and end-stage renal disease,” Kristin Nelson, BS, and Joseph Wysocki, BS, of Michigan State University, wrote in their study. “This disease impacts nearly 30 million American adults, with many more at risk of developing the disease. Treatment for these patients includes diet modification, lifestyle changes, renal replacement therapy and kidney transplantation.”
For this investigation, researchers focused on diet modification, reviewing evidence on the effects of probiotic supplementation on CKD.
One of the many complications patients with CKD experience, according to the researchers, is constipation (common in 29% of patients on PD and 63% of patients on hemodialysis). Constipation — caused by low fiber intake, low fluid consumption, lack of activity and other comorbidities — can lead to alterations in the gut microbiota and bacterial overgrowth in the stool. The bacteria produce uremic toxins and are associated with the progression of CKD.
One study reviewed assigned 24 patients with CKD to the experimental group (low-protein diet with prebiotic and probiotic supplements) or the control group (low-protein diet and no supplements). Results showed the declining eGFR improved in participants who consumed a low-protein diet supplemented by prebiotics and probiotics.
The researchers also considered a study in which patients with CKD were given prebiotics and probiotics or a placebo. Here, it was determined that patients who consumed Lactobacillus, Bifidobacteria and Streptococcus with prebiotics had positive changes to the stool microbiome, as well as a decrease of p-cresol and indoxyl sulfate in their gastrointestinal tract.
“These studies show that the regular consumption of probiotics has the potential to improve the quality of life in patients with CKD,” the authors wrote.
According to the Nelson and Wysocki, probiotic-containing foods that nephrologists can recommend patients add to their diet include:
- yogurt;
- kimchi;
- kombucha;
- tempeh;
- kefir;
- sauerkraut; and
- miso. – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.