Table 3.
Studies reporting gut microbiota modulation in CKD patients.
| Study, Year | Type of Therapy | Results |
|---|---|---|
| Abdelbary et al., 2022 [75] | Sucroferric oxyhydroxide | In hemodialysis patients, Veillonella spp. and Ruminococcus torques levels increased (p = 0.0351 for both), while Subdoligranulum decreased (p = 0.0496). |
| Belova et al., 2020 [78] | Immobilized synbiotic LB-complex L vs. placebo | In 56% of patients in the treatment group, gut microbiota recovered as compared to placebo (grade III dysbiosis was absent after therapy). CRP decreased from 6.8 ± 3.1 g/L to 5.3 g/L in the treatment group. |
| Borges et al., 2017 [79] | Probiotics | Gut microbiota profile was similar in the probiotic group (Streptococcus thermophilus, Lactobacillus acidophilus, and Bifidobacteria longum strains) and placebo group after 3 months of therapy (similar number of bands). |
| Ebrahim et al., 2022 [80] | β-glucan prebiotic | Prevotella tended to increase in the intervention group (β-glucan) as compared to the control group, while Bacteroides and Blautia tended to decrease. |
| Hu et al., 2022 [66] | Dietary intervention | HD patients from the protein-energy wasting group had lower abundance of Roseburia as compared to HD patients in the non-protein energy wasting group (p = 0.022). Escherichia abundance was increased in PD patients from the protein-energy wasting group compared to PD patients from the non-protein-energy wasting group (p = 0.022). |
| Iguchi et al., 2020 [31] | Sucroferric oxyhydroxide | In HD patients, sucroferric oxyhydroxide did not affect major phyla (p = 0.849 for Firmicutes, p = 0.776 for Proteobacteria, p = 0.517 for Actinobacteria, p = 0.728 for Bacteroides). |
| Jiang et al., 2020 [67] | Dietary intervention | Patients with CKD stage 5 who received a very low protein diet had higher levels of Escherichia, Shigella, and Klebsiella, while Blautia was decreased. |
| Kemp et al., 2021 [81] | Resistant starch type-2 | Resistant starch type-2 increased Oscillosperaceae, Roseburia, and Ruminococcus gauvreauii levels. Resistant starch type-2 decreased Ruminococcus champanellens, Dialister, and Coprococcus. |
| Kimber et al., 2020 [82] | Rifaximin | Rifaximin was linked to reduced diversity and richness of microbiota as compared to placebo. Rifaximin reduced 10 bacterial taxa from Firmicutes and Actinobacteria phyla (including Clostridium, Turicibacter, and Anaerotruncus). |
| Laffin et al., 2019 [89] | Amylose-resistant starch | Amylose-resistant starch increased levels of Faecalibacterium in ESKD patients as compared to placebo (from 0.40 ± 0.50% to 3.21 ± 4.97%, p = 0.03), while Parabacteroides, Bifidobacteria, Ruminococcus, and Prevotella levels did not change. |
| Lai et al., 2019 [37] | Low-protein diet | Low-protein diet increased Akkermansiaceae and Bacteroidaceae and decreased Christensenellaceae, Clostridiaceae, Lactobacillaceae, and Pasteurellaceae levels. |
| Low-protein diet + inulin | Low-protein diet associated with inulin therapy increased Bifidobacteriaceae levels. | |
| Inulin | Inulin decreased Enterobacteriaceae family. | |
| Liu et al., 2020 [83] | Probiotics | Probiotics increased Bacteroidaceae and Enterococcaceae abundance compared to placebo. Probiotics decreased Ruminococcaceae, Halomonadaceae, Peptostreptococcaceae, and Clostridiales Family XIII levels compared to placebo. |
| Liu et al., 2022 [76] | Iron supplementation | After oral iron supplementation, α-diversity and Firmicutes levels decreased, while Bacteroides increased. Moreover, Blautia and Coprococcus levels decreased, while Bacteroidetes increased. |
| McFarlane et al., 2021 [84] | Synbiotics vs. placebo | Synbiotic therapy increased Bifidobacterium animalis (p < 0.001) and Blautia spp. levels (p = 0.004). Synbiotics decreased Bacteroides cellulosilyticus and Ruminiclostridium spp. (p < 0.05 for both). Synbiotic therapy was linked to eGFR decrease with 3.14 mL/min/1.73 m2 (p < 0.01). |
| Miao et al., 2018 [63] | Lanthanum carbonate | In HD patients, lanthanum carbonate decreased Bacteroides and Proteobacteria but increased Actinobacteria levels. Shannon index decreased following lanthanum carbonate therapy. |
| Cruz-Mora et al., 2014 [85] | Synbiotics | In HD patients, synbiotic therapy increased Bifidobacterium abundance (p = 0.0344) but decreased Lactobacillus levels. |
| Nazzal et al., 2017 [77] | Oral vancomycin | Following vancomycin therapy, Clostridia, Roseburia, Enterococcaceae, and Bacteroidales decreased, while Veillonellaceae increased. |
| Pivari et al., 2022 [48] | Curcumin supplementation | After 6 months of dietary intervention, Escherichia-Shigella levels significantly decreased, while Lachnoclostridium and Lactobacillaceae spp. increased. |
| Rocchetti et al., 2021 [86] | Dietary intervention | The keto analogs-supplemented Mediterranean diet reduced Clostridiaceae, Methanobacteriaceae, Prevotellaceae, and Lactobacillaceae abundance, while Bacteroidaceae and Lachnospiraceae levels increased. |
| Rossi et al., 2016 [87] | Synbiotics | Compared to placebo, synbiotics were linked to a 5-fold increase in Bifidobacterium spp. (p = 0.003), while Lactobacillus spp. abundance was similar. |
| Simeoni et al., 2019 [88] | Probiotics | Compared to the placebo group, probiotics increased Lactobacillales and Bifidobacteria levels from 2.1 × 103 CFU/gr and 1.9 × 104 CFU/gr to 2.2 × 106 CFU/gr and 2.5 × 107 CFU/gr, respectively (p < 0.001 for both). Iron and ferritin levels were significantly increased after probiotic therapy (p < 0.001 for both), while CRP, total cholesterol, and triglycerides levels were decreased in patients who received probiotics (respectively, p < 0.001, p < 0.01, and p < 0.01). |
| Wu et al., 2020 [64] | Dietary intervention | CKD patients who received a low protein diet had lower levels of Lachnospiraceae and Bacteroidaceae as compared to those receiving a normal protein diet. |
| Wu et al., 2020 [65] | Phosphate binders | α-diversity and Simpson index were decreased in HD patients receiving calcium carbonate compared to the ferric citrate group (respectively, p = 0.049 and p = 0.001). Patients receiving ferric citrate had increased levels of Bacteroidetes phylum levels, while Firmicutes phylum was decreased. |
| Yacoub et al., 2017 [68] | Advanced glycation end products | PD patients who received a one-month advanced glycation end-product restriction had a lower abundance of Prevotella copri compared to those with a normal diet. |
CKD = chronic kidney disease; CRP = C-reactive protein; eGFR = estimated glomerular filtration rate; HD = hemodialysis; PD = peritoneal dialysis.