. 2019 Feb 13;7(1):21. doi: 10.3390/diseases7010021

Table 1.

Studies that examined prebiotics and/or probiotics in patients or animals with chronic kidney disease.

Species	Dietary Intervention	Study Type	Outcomes	References
Prebiotics
Mice	Short-chain fatty acids (acetate, propionate, and butyrate, pH 7.4 diluted in PBS)	Pilot study	Delayed progression of chronic kidney disease. Improved mitochondrial biogenesis. Reduced local and systemic inflammation, cellular oxidative stress, cell infiltration/activation and apoptosis.	[183]
Rat	Amylose maize resistant starch	Original research study	Attenuation of oxidative stress and inflammation. Delayed progression of chronic kidney disease.	[44]
Rat	High amylose maize-resistant starch type 2 (HAMRS2)	Original research study	Reduction in serum and urine indoxyl sulfate levels. Reduction in urine p-cresol level. Improvements in kidney function indexes and amelioration of chronic kidney disease outcomes.	[164]
Human	Gum arabic (highly fermentable fiber)	Clinical trial	Significant decrease in serum urea nitrogen. Significant increase in fecal bacterial mass and fecal nitrogen content.	[184]
Human	Fermentable carbohydrate	Clinical trial	Significant increase in stool nitrogen excretion. Significant decrease in the urinary nitrogen excretion. Unchanged total nitrogen excreted by the two routes. Significant decrease in plasma urea levels.	[185]
Human	Resistant starch	Clinical trial	Significant reduction in plasma indoxyl sulfate. Insignificant reduction in plasma p-cresyl sulfate.	[186]
Human	Soluble dietary fiber	Clinical trial	Significant decrease in total cholesterol (TC), low-density lipoprotein (LDL), and TC: LDL ratio. Significant decrease in malondialdehyde, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, and C-reactive protein levels. No changes in triglycerides, high-density lipoprotein, Cu–Zn superoxide dismutase, and glutathione peroxidase levels.	[187]
Human	Arabinoxylan oligosaccharides	Clinical trial	No significant effect on serum p-cresyl sulfate, p-cresyl glucuronide, indoxyl sulfate and phenylacetylglutamine. Small, albeit significant decrease in serum trimethylamine N-oxide. No change in the urinary excretion of p-cresyl sulfate, p-cresyl glucuronide, indoxyl sulfate phenylacetylglutamine, and trimethylamine N-oxide. No significant change in homeostatic model assessment. No influence on microbiota-derived uremic retention solutes and insulin resistance.	[188]
Probiotics
Rat	Various combinations of Bacillus pasteurii, Sporolac, Kibow cocktail, CHR Hansen Cocktail, and Econorm	Pilot study	Improved survival. Reduction in blood urea nitrogen levels. Delayed progression of chronic kidney disease.	[189]
Rat	Soil-borne alkalophilic urease-positive bacterium Sporosarcina pasteurii	Pilot study	Reduced blood urea nitrogen levels. Improved survival.	[190]
Rat	Escherichia coli DH5 given with urease	Original research study	Reduction of the high plasma urea level to normal	[191]
Dog	VSL#3 supplementation	Original research study	Significant increase in estimated glomerular filtration rate.	[192]
Human	L. acidophilus, S. thermophilus and B. longum	Clinical trial	Significant reduction in blood urea nitrogen levels. Improved quality-of-life scores.	[171]
Human	L. acidophilus, S. thermophilus, B. longum	Clinical trial	Significant reduction of blood urea nitrogen. Moderate reduction in uric acid levels. Insignificant changes in serum creatinine. Improved quality of life scores.	[193]
Human	B. longum	Clinical trial	Significant decrease in predialysis serum levels of homocysteine, indoxyl sulfate, and triglycerides.	[194]
Human	B. longum	Clinical trial	Reduction in serum indoxyl sulfate.	[195]
Human	B. longum	Clinical trial	Delayed progression of chronic kidney disease.	[196]
Human	Lebenin (antibiotic-resistant lactic acid bacteria)	Clinical trial	Reduction in levels of uremic toxins (especially the plasma level of indican).	[67]
Human	L. acidophilus	Clinical trial	Reduction of serum dimethylamine and nitrosodimethylamine. Improved nutritional status.	[197]
Human	Streptococcus thermophilus, Lactobacillus acidophilus and Bifidobacteria longum	Clinical trial	Significant increase in serum urea nitrogen. Reduction in fecal pH. No effect on inflammatory markers and gut microbiome profile.	[172]
Human	Bifobacterium bifidum, Bifidobacterium catenulatum, Bifidobacterium longum and Lactobacillus plantarum	Clinical trial	Significant reduction in serum TNF-α, IL-5, IL-6, and endotoxin. Significant increase in serum IL-10 levels.	[198]
Human	S. thermophilus, L. acidophilus, and B. longum	Clinical trial	Non-significant improvement in quality-of-life scores. Non-significant reduction of serum indoxyl glucuronide and C-reactive protein.	[173]
Human	Lactobacillus casei shirota	Clinical trial	>10% decrease in serum urea concentrations.	[199]
Human	Probiotics	Meta-analysis	Significant reduction in urea level in non-dialysis patients but no change in dialysis patients. No effects on uric acid, C-reactive protein, creatinine, and estimated glomerular filtration rate.	[200]
Human	Probiotics	Meta-analysis	Decrease in p-cresyl sulfate. Increase in IL-6. No effects on serum creatinine, blood urine nitrogen, C-reactive protein and hemoglobin levels.	[201]
Synbiotics
Human	Prebiotics; galactooligosaccharides Probiotics: Lactobacillus casei strain Shirota and Bifidobacterium breve strain Yakult	Clinical trial	Significant decrease in serum p-cresol level. Normalization of bowel habits.	[182]
Human	Prebiotics: inulin high performance, fructo-oligosaccharides, and galactooligosaccharides Probiotics: Lactobacillus, Bifidobacteria, and Streptococcus species	Clinical trial	Significant decrease in serum p-cresyl sulfate. Favorable modification of the stool microbiome.	[181]
Human	Prebiotics: Fructooligosaccharides Probiotics: Lactobacilus casei, Lactobacilus acidophilus, Lactobacilus bulgarigus, Lactobacilus rhamnosus, Bifidobacterium breve, Bifidobacterium longum, and Streptococcus thermophilus	Clinical trial	Significant reduction in blood urea nitrogen levels.	[202]
Human	Prebiotics: Fructooligosaccharides Probiotics: Streptococcus thermophiles, Lactobacillus acidophilus, Bifidobacterium longum	Clinical trial	Significant lowering of the rate of decline in estimated glomerular filtration rate.	[203]
Human	Commercial symbiotic formulation: Probinul neutro	Clinical trial	Significant reduction in total plasma p-cresol level.	[204]
Human	Prebiotic and Probiotics	Meta-analysis	Synbiotic interventions significantly increased Bifidobacterium in gut microbiota, but had little or no effect on serum urea nitrogen, indoxyl sulfate, and p-cresyl sulfate. Prebiotic supplementation may slightly reduce serum urea concentration.	[205]