Table 3.
Summary of findings of resistant starch type 2 (RS2) for end stage renal disease patients under maintenance hemodialysis
| Patient or population: patients with chronic kidney disease; Intervention: RS2 | ||||
|---|---|---|---|---|
| Outcomes | Illustrative comparative risks* (95% CI) | No. of Participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | |||
| Control | RS2 | |||
| BUN | The mean BUN in the intervention groups was 6.91 mg/dL lower (11.87 to 1.95 lower) | 148 (4 studies) | ⊕⊕⊝⊝ low1,2 | |
| Scr | The mean Scr in the intervention groups was 1.11 mg/dL lower (2.18 to 0.05 lower) | 119 (3 studies) | ⊕⊝⊝⊝ very low1,3,4 | |
| UA | The mean UA in the intervention groups was 0.17 mg/dL higher (0.23 lower to 0.58 higher) | 108 (3 studies) | ⊕⊕⊝⊝ low1,5 | |
| IS | The mean IS in the intervention groups was 0.33 SD lower (0.7 lower to 0.04 higher) | 115 (3 studies) | ⊕⊝⊝⊝ very low1,3,6 | |
| PCS | The mean PCS in the intervention groups was 0.31 SD lower (0.68 lower to 0.06 higher) | 115 (3 studies) | ⊕⊕⊝⊝ low1,3 | |
| IL-6 | The mean IL-6 in the intervention groups was 1.08 SD lower (1.64 to 0.53 lower) | 95 (3 studies) | ⊕⊕⊝⊝ low1,3 | |
| hsCRP | The mean hsCRP in the intervention groups was 0.17 SD higher (0.22 lower to 0.56 higher) | 119 (3 studies) | ⊕⊕⊝⊝ low1,3 | |
| Albumin | The mean albumin in the intervention groups was 0.06 g/dL higher (0.06 lower to 0.18 higher) | 159 (4 studies) | ⊕⊕⊝⊝ low1,3 | |
| Phosphate | The mean phosphate in the intervention groups was 0.03 mg/dL lower (0.36 lower to 0.30 higher) | 179 (5 studies) | ⊕⊕⊝⊝ low1,3 | |
*The basis for the assumed risk (i.e. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI);BUN: blood urea nitrogen; CI: confidence interval; hsCRP: high sensitive C-reaction protein; IL-6: interleukin 6; IS: indoxyl sulfate; PCS: p-cresol sulfate; RS2: resistant starch type 2; Scr: serum creatinine; SD: standard deviation; UA: uric acid.
GRADE Working Group grades of evidence:High quality: Further research is very unlikely to change our confidence in the estimate of effect;Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate;Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate;Very low quality: Very uncertain about the estimate.
1 Imprecise due to the small sample size (less than 300) in all studies. Thus, the evidence quality was down-graded as one level.2 One study was inconsistent with the other three in BUN, thus the quality of evidence was down-graded by one level.3 One study was supported by food company of RS2, thus the quality of evidence was down-graded by one level.4 One study was inconsistent with the other two in Scr, thus the quality of evidence was down-graded by one level.5 One study was inconsistent with the other two in UA, thus the quality of evidence was down-graded by one level.6 One study was inconsistent with the other two in IS, thus the quality of evidence was down-graded by one level.