Table 2.
Diet treatments for the control of UTs.
| Intervention | Route, Dosage and Frequency | Author/Year | Mechanism/Usage | Study Design | Subjects | Subject Number | Result |
|---|---|---|---|---|---|---|---|
| Clinical Studies | |||||||
| Prebiotics—OF-IN | Oral, 10 g, BID | Meijers et al., 2010 [54] | Modulating intestinal microbiota | Open-label phase I/II study | Patients undergoing HD | 22 | PCS ↘ |
| Probiotics: L. acidophilus KB27, B. longum KB31, and S. thermophilus KB19 | Oral, 2 capsules, TID | Ranganathan et al., 2010 [55] | Modulating intestinal microbiota | RCT | Patients with CKD stages 3 and 4 | 46 | BUN ↘, Cr ↘, UA ↘ |
| Probiotics: B. longum | Oral, 3–12 × 109 CFU/day | Taki et al., 2005 [56] | Modulating intestinal microbiota | Case series | Patients undergoing HD | 27 | Hcy ↘, IS ↘ |
| SCFA: sodium propionate | Oral, 1 g, QD | Marzocco et al., 2018 [57] | Anti-inflammation and antioxidation | Clinical trial | Patients undergoing HD | 20 | IS ↘, MDA ↘, PCS ↘ |
| Synbiotic: L. casei, B. breve, and galactooligosaccharides | Oral, 1 pack, TID | Nakabayashi el et al., 2011 [58] | Modulating intestinal microbiota | Clinical trial or case series | Patients undergoing HD | 9 | p-Cresol ↘ |
| Vegetarian | Oral | Kandouz et al., 2016 [59] | Improvement of metabolic acidosis, modification of intestinal microbiota | Cohort | Patients in hemodiafiltration | 138 | IS ↘, PCS ↘, Urea ↘ |
| Vitamin D | Oral, 300,000 IU, QD | Kumar et al., 2017 [53] | Anti-inflammation | RCT | Patients with nondiabetic CKD and vitamin D deficiency | 120 | IL-6 ↘, UA ↘ |
| Animal Studies | |||||||
| Diet® k/d® | Oral, 1.6 RER, QD | Hall et al., 2018 [60] | Anti-inflammation | Animal | CKD dogs | 36 | BUN ↘, Cr ↘, SDMA ↘ |
| Lingonberry | Oral, 5% w/w, QD | Madduma Hewageet al., 2020 [61] | Anti-inflammation | Animal | HFD-induced kidney injury mice | 30 | BUN ↘, Cr ↘, IL-6 ↘, TNF-α ↘ |
| MitoQ | i.v., 4 mg/kg, once | Hu et al., 2018 [62] | Antioxidation through reducing mitochondrial ROS | Animal | I/R mice | 24 | Cr ↘, IL-1β ↘, IL-6 ↘, TNF-α ↘ |
| Soluble Fiber and Omega-3 | Oral, 3666 kcal/kg, QD | Ephraim et al., 2020 [63] | Modulating intestinal microbiota | Animal | Dogs aged older than 7 years | 36 | phenolic UTs ↘, SDMA ↘ |
↘, decrease; BUN, blood urea nitrogen; BID, bis in die; CFU, colony-forming units; CKD, chronic kidney disease; Cr, creatinine; Hcy, homocysteine; HD, hemodialysis; HFD, high-flux dialysis; I/R, ischemia/reperfusion; IL-1β, interleukin-1 beta; IL-6, interleukin 6; IS, indoxyl sulfate; IU, International unit; i.v., intravenous; MDA, malondialdehyde; MitoQ, mitoquinone; OF-IN, oligofructose-enriched inulin; PCS, p-cresyl sulfate; QD, quaque die; RER, resting energy requirement; RCT, randomized controlled trial; SCFA, short-chain fatty acids; SDMA, symmetric dimethylarginine; UA, uric acids; UTs, uremic toxins.