Table 2.
Summary of human studies involving prebiotics interventions in CKD patients.
| References | Study Design, Sample, Follow-up | Prebiotics | Results |
|---|---|---|---|
| Younes et al, 2006 [58] | RCT with crossover; 9 non-dialysis CKD patients; 5 weeks | 40 g/day fermentable carbohydrate (25 g whole-meal bread + 4.5 g inulin + 10.5 g crude potato starch) | ↑ stool weight, fecal and urinary urea, fiber intake No change in eGFR |
| Meijers et al, 2010 [56] | Non-randomized, single-center, open-label phase; 22 HD patients; 4 weeks | 10–20 g/day of oligofructose-enriched inulin | ↓ 20% serum p-CS, generation rate and BUN ↔ IS serum or generation rates |
| Sirich et al, 2014 [52] | RCR; 56 HD patients; 6 weeks | 15 g/day of high-amylose corn starch | ↓ IS and a trend to p-CS free plasma ↔ body weight, CRP |
| Salmean et al, 2015 [53] | Single-blind, placebo controlled; 13 non-dialysis CKD patients; 6 weeks | 10 g/day of pea hull fiber (Best Pea Fiber; Best Cooking Pulses, Portage la Prairie, Manitoba, Canada) + 15 g/day inulin | ↓ 20% total plasma p-CS, ↑ stool frequency, fiber intake ↔ CRP, cystatin C, BUN, ammonia, eGFR |
| Poesen et al, 2016 [57] | RCT with crossover; 40 non-dialysis CKD patients; 4 weeks | 10 g twice/day of arabinoxylan oligosaccharide | ↓serum TMAO ↔ IS, p-Cs, p-Cglucuronide and phenylacetylglutamine, HOMA-IR |
| Tayebi-Khosroshahi et al, 2016 [51] | RCT; 32 non-dialysis CKD patients; 8 weeks | 30 mm thrice/day of lactulose syrup | ↑ fecal bifidobacteria and lactobacillus counts ↓ Cr |
| Tayebi Khosroshahi et al, 2018 [59] | RCT; 46 HD patients; 4 weeks | 20–25 g/day of high amylose maize resistant starch | ↓ TNF-α, IL-6, MDA, severity constipation, serum urea and creatinine ↔ IL-1β, hs-CRP, total antioxidant activity |
| Esgalhado et al, 2018 [16] | RCT; 31 HD patients; 4 weeks | 16 g/day resistant starch (Hi-Maize® 260) | ↓ IL-6, TBARS, IS and a trend to protein carbonylation; ↑ fiber intake ↔ CRP, p-CS |
Abbreviations: HD: hemodialysis; CKD: chronic kidney disease; RCT: randomized clinical trial; Cr: creatinine; CRP: C-reactive protein; FOS: fructooligosaccharide; p-CS: p-cresyl sulfate; IAA: indole-3-acetic acid; IS: indoxyl sulfate; TMAO: trimethylamine-N-oxide; IL: Interleukin; HOMA-IR: homeostatic model assessment- insulin resistance; hs-CRP: high sensitivity C-reactive protein; ↔: no change; ↑: increase; ↓: decrease; eGFR: estimated glomerular filtration rate; BUN: Blood urea nitrogen; TNF: Factor de necrose tumoral; MDA: malondialdehyde.