Table 1.
Characteristic of randomized controlled trials that included for analysis; effects of probiotics on clinical manifestations of Diabetic Nephropathy
| First author (publication year) | Country | Analyzed Sample sizeIn/Co Male/Female | Target population | Disease duration M (SD) |
BMI at base (M) |
Age (M) |
Study design Duration |
Intervention, Dose |
Control, Dose |
Probiotic content and numbers | Investigated markers |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Abbasi (2018) | Iran |
20/20 19/21 |
Diabetic Nephropathy | 7.8 (3.5) | 26.6 | 55.2 |
R, DB, PC Parallel 8 wks |
Probiotics soy milk 200 ml QD |
soy milk 200 ml QD |
Lactobacillus plantarum A7 2 × 107 CFU/ml Totally 4 × 109 CFU |
TG, TC, LDL-C, HDL-C, non HDL-C, Serum creatinine, Serum phosphorus, Serum genistein, eGFR |
| Abbasi (2017) | Iran |
20/20 19/21 |
Diabetic Nephropathy | 7.8 (3.5) | 26.6 | 55.2 |
R, DB, PC Parallel 8 wks |
Probiotics soy milk 200 ml QD |
soy milk 200 ml QD |
lactobacillus plantarum A7 2 × 107 CFU/ml Totally 4 × 109 CFU |
Body Weight, BMI, WHR, IL-18, Serum sialic acid, Serum creatinine, Serum genistein, eGFR, Urinary albumin/creatinine ratio |
| Mafi (2018) | Iran |
30/30 NR |
Diabetic Nephropathy | 18.1 (5.4) | 25.8 | 59.9 |
R, DB, PC Parallel 12 wks |
Probiotic capsule QD |
Placebo capsule (contained only starch) QD |
Lactobacillus acidophilus strain ZT-L1, Bifidobacterium bifidum strain ZT-B1, Lactobacillus reuteri strain ZT-Lre, and Lactobacillus fermentum strain ZT-L3 (each 2 × 109 CFU/g) Totally 8 × 109 CFU per capsule |
Body Weight, BMI, TAC, MDA, hs-CRP, FPG, Insulin, GSH, HOMA-IR, NO, QUICKI, TC, TG, LDL-C, HDL-C, VLDL-C, Hb A1C, TC/HDL ratio, AGEs, BUN, Serum creatinine, GFR, Urine protein, gene expression (IL-1, TNF-α, TGF-ß, PPAR-γ and LDLR) |
| Miraghajani (2019) | Iran |
20/20 19/21 |
Diabetic Nephropathy | 7.8 (3.5) | 26.6 | 55.2 |
R, DB, PC Parallel 8 wks |
Probiotics soy milk 200 ml QD |
soy milk 200 ml QD |
Lactobacillus plantarum A7 (KC355240, LA7) 2 × 107 CFU/ml Totally 4 × 109 CFU |
Calorie, Protein, Fat, Carbohydrate, Fiber, Calcium, Magnesium, Potassium, NGAL, sTNFR1, Cys-C, PGRN, Weight, WHR, BMI |
| Soleimani (2017) | Iran |
30/30 40/20 |
Diabetic Hemodialysis | 18.1 (5.4) | 26.2 | 56.7 |
R, DB, PC Parallel 12 wks |
Probiotic capsule QD |
Placebo capsule (contained only starch) QD |
Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum (each 2 × 109 CFU/g) Totally 6 × 109 CFU per capsule |
Body Weight, BMI, MET, TAC, MDA, hs-CRP, FPG, Insulin, GSH, HOMA-IR, HOMA-B, NO, QUICKI, TC, TG, LDL-C, HDL-C, VLDL-C, Hb A1C, TC/HDL ratio, BUN, Serum creatinine, GFR, SGA score, Albumin, TIBC, Na, K |
| Arani (2019) | Iran |
30/30 NR |
Diabetic Nephropathy | 18.1 (5.4) | 26.2 | 56.7 |
R, DB, PC Parallel 12 wks |
Probiotic honey 25 g QD |
Control honey 25 g QD |
Bacillus coagulans T4 (IBRC-N10791) (108 CFU/g) Totally 2.5 × 109 CFU |
Body Weight, BMI, TAC, MDA, hs-CRP, FPG, Insulin, GSH, HOMA-IR, NO, QUICKI, TC, TG, LDL-C, HDL-C, VLDL-C, TC/HDL ratio, BUN, Serum creatinine |
| Miraghajani (2017)† | Iran |
20/20 NR |
Diabetic kidney disease | 7.8 (3.5) | 26.6 | 55.2 |
R, DB, PC Parallel 8 wks |
Probiotics soy milk 200 ml QD |
soy milk 200 ml QD |
Lactobacillus plantarum A7 (KC355240, LA7) 2 × 107 CFU/ml Totally 4 × 109 CFU |
Calorie, Protein, Fat, Carbohydrate, Fiber, Cholesterol, MUFA, PUFA, Saturated fatty acid, Selenium, Vitamin E, and C, MDA, TAC, GSH, 8-iso-PGF2a, Oxidized glutathione, Glutathione peroxidase, Glutathione reductase |
†One selected study was just systematically reviewed and not included in analysis due to irrelevant outcome markers
Functional abbreviations: In, intervention group; Co, control group; M, mean; SD, standard deviation; QD, once a day; CFU, colony forming unit; RDBPC, randomized double blind placebo control trial; wks, weeks; NR, not reported
Study outcome abbreviations: hs-CRP, high sensitive C-reactive protein; MDA, malondialdehyde; TAC, total antioxidant capacity; IL interleukin; FPG, fasting plasma glucose; GHQ, general health questionnaire; GSH, total glutathione; HOMA-IR, homeostasis model of assessment-estimated insulin resistance; HOMA-B, homeostasis model of assessment estimated B cell function; NO, nitric oxide; QUICKI, quantitative insulin sensitivity check index; TG, Triglycerides; TC, Total cholesterol; LDL, low density lipoprotein; VLDL, very low density lipoprotein; HDL, high density lipoprotein; TG, triacylglycerol; AGEs, advanced glycation end products; GFR, glomerular filtration rate; BUN, blood urea nitrogen; LDLR, low-density lipoprotein receptor; PPAR-γ, peroxisome proliferator-activated receptor gamma; TNF-α, tumor necrosis factor alpha; TGF-ß, transforming growth factor beta; HbA1c, hemoglobin A1c; NGAL, neutrophil gelatinase-associated lipocalin; sTNFR1, soluble tumor necrosis factor receptor 1; PGRN, Progranulin; Cys-C, cystatin C; METs, metabolic equivalents; SGA, subjective global assessment; TIBC, total iron binding capacity; Na, sodium; K, potassium; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid; 8-iso-PGF2a, 8-iso-prostaglandin F2a