Table 1.
Basic characteristics of the included studies.
| References | Country | Type of study | Participant | Intervention/control | Diet restrictions | Sample size (I/C) | Period (weeks) | Male (I/C) (n) | Age (years) | BMI (kg/m2) |
|---|---|---|---|---|---|---|---|---|---|---|
| Abbasi et al. (19) | Iran | RCT (double-blind, placebo-controlled) | DN | Probiotic (lactobacillus plantarum A7)/placebo | 0.8 g/kg protein, 2,000 mg sodium, 2,000 mg potassium and 1,500 mg phosphorus | 20/20 | 8 | NA | 55.25 ± 7.74 | 26.63 ± 3.29 |
| Borges et al. (7) | Brazil | RCT (double-blind, placebo-controlled) | HD | Probiotic (Streptococcus thermophilus, Lactobacillus acidophilus, and Bifidobacteria longum)/placebo | NA | 16/17 | 12 | 11/10 | 51.90 ± 9.78 | 25.25 ± 5.12 |
| Borges et al. (8) | Brazil | RCT (double-blind, placebo-controlled) | HD | Probiotic (Streptococcus thermophilus, Lactobacillus acidophilus, and Bifidobacteria longum)/placebo | NA | 11/10 | 12 | 3/4 | 54.00 ± 8.16 | 25.70 ± 4.43 |
| Cosola et al. (20) | Italy | RCT (single-blind, placebo-controlled) | CKD stage 3b-4 | Synbiotic (Lactobacillus Casei, Bifidobacterium Animalis, fructoligosaccharides, and inulin)/placebo | NA | 13/10 | 8 | 7/7 | 51.22 ± 3.65 | 26.59 ± 1.17 |
| de Andrade et al. (9) | Brazil | RCT (double-blind, placebo-controlled, crossover) | APD | Prebiotic (unripe banana flour-48% resistant starch)/placebo | To maintain a stable dietary pattern and not to take additional microbiological agents during intervention | 15/11 | 12 | NA | 55.00 ± 12.00 | 26.7 ± 4.1 |
| Esgalhado et al. (21) | Brazil | RCT (double-blind, placebo-controlled) | HD | Prebiotic (cookies and powder-resistant starch)/placebo | Patients were asked about the amount and type of food eaten at each meal held during the day | 15/16 | 4 | 7/11 | 54.71 ± 9.69 | 26.41 ± 5.07 |
| Eidi et al. (22) | Iran | RCT (triple-blind, placebo-controlled) |
HD | Prebiotic (Lactobacillus Rhamnosus)/placebo | Not to change their usual dietary intakes | 21/21 | 4 | 15/17 | 58.36 ± 14.39 | 24.46 ± 4.60 |
| Haghighat et al. (23) | Iran | RCT (double-blind, placebo-controlled) | HD | Probiotic (Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium longum)/placebo | To maintain stable dietary intakes, and not to consume any supplements other than the one provided to them by the trial | 23/19 | 12 | 12/10 | 45.88 ± 11.04 | 22.69 ± 4.04 |
| Synbiotic (Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium lactis, Bifidobacterium longum, fructo-oligosaccharides, galactooligosaccharides, inulin)/placebo | 23/19 | 12 | 12/10 | 46.88 ± 10.36 | 23.64 ± 4.91 | |||||
| Jiang et al. (24) | China | RCT (double-blind, placebo-controlled) | DN | Probiotic (Bifidobacterium bifidum, Lactobacillus acidophilus, Streptococcus thermophilus)/placebo | NA | 42/34 | 12 | 15/12 | 56.03 ± 8.3 | 27.03 ± 3.06 |
| Kooshki et al. (25) | Iran | RCT (double-blind, placebo-controlled) | HD | Synbiotic (Lactobacillus coagulans and fructo-oligosaccharides)/placebo | Not to change their dietary habits | 23/23 | 8 | 10/11 | 62.88 ± 16.52 | 23.53 ± 4.08 |
| Mafi et al. (26) | Iran | RCT (double-blind, placebo-controlled) | HD | Probiotic (Lactobacillus acidophilus strain, Bifidobacterium bifidum strain, Lactobacillus reuteri strain, and Lactobacillus fermentum strain)/placebo | NA | 30/30 | 12 | NA | 59.9 ± 6.97 | 25.80 ± 2.81 |
| Miraghajani et al. (27) | Iran | RCT (double-blind, placebo-controlled) | DN | Probiotic (soy milk-Lactobacillus plantarum A7)/placebo | Participants received individualized dietary counseling aimed at achieving a daily energy and restricting dietary protein, sodium, and potassium intake. | 20/20 | 8 | 12/10 | 55.25 ± 2.37 | 25.80 ± 2.81 |
| Ramos et al. (28) | Brazil | RCT (double-blind, placebo-controlled) | NDD-CKD | Prebiotic (fructo-oligosaccharides)/placebo | Keep a diet composed by 0.6–0.8 g/kg/day of protein, 30–35 kcal/kg/day of energy, restricted in sodium and controlled in potassium if necessary | 23/23 | 12 | 13/14 | 57.50 ± 14.55 | 26.63 ± 0.71 |
| Simeoni et al. (29) | Italy | RCT (open-label, placebo-controlled) | CKD stage 3a | Probiotic (Lactobacillales and Bifidobacteria)/placebo | Protein dietary intake ranging 0.7–1 g/ kg/day, daily consumption of two pieces of fruit (apple or pear) and 200 g of double-boiled leafy green vegetables | 14/14 | 12 | 9/6 | 59.75 ± 5.83 | 27.60 ± 4.96 |
| Soleimani et al. (30) | Iran | RCT (double-blind, placebo-controlled) | DN + HD | Probiotic (Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum)/placebo | Not to change usual diets and not take any anti-inflammatory and antioxidant medications or supplements during the intervention. | 30/30 | 12 | 20/20 | 56.70 ± 16.10 | 25.85 ± 5.44 |
| Soleimani et al. (31) | Iran | RCT (double-blind, placebo-controlled) | DN + HD | Synbiotic (Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum, and inulin)/placebo | Not to change usual diets and not take any anti-inflammatory and antioxidant medications or supplements during the intervention | 30/30 | 12 | 21/21 | 62.8 ± 13.67 | 25.70 ± 2.90 |
| Guida et al. (32) | Italy | RCT (double-blind, placebo-controlled) | KTRs | Synbiotic (Lactobacillales, Bifidobacteria, Streptococcus thermophilus), prebiotic inulin, and tapioca-resistant starch)/placebo | Mediterranean pattern diet; energy intake higher than 25/kcal/kg/ideal body weight/day, 55% of carbohydrates, total fat not exceeding 30% of calories (fatty acids <10% of calories and dietary cholesterol limited to 300 mg/day); protein intake is restricted to 0.8 g/kg of ideal body weight/day; insoluble and soluble fibers in a ratio of about 3 to 1; water intake ranges between 1.5 and 2.0 L/day | 22/12 | 4 | 16/12 | 51.64 ± 9.22 | 26.65 ± 5.03 |
| Shariaty et al. (33) | Iran | RCT (double-blind, placebo-controlled) | HD | Probiotic (Lactobacillus acidophilus, Bifidobacterium and Streptococcus thermophilus)/placebo | Both groups received daily folic acid supplements and monthly vitamin B12 supplements | 17/17 | 4 | 10/10 | 57.84 ± 11.83 | NA |
| Sirich et al. (34) | The United States | RCT (single-blind, placebo-controlled) | HD | Prebiotic (resistant starch)/placebo | NA | 20/20 | 6 | 11/13 | 56.00 ± 13.49 | 25.34 ± 2.85 |
| Viramontes-Hörner et al. (35) | Mexico | RCT (double-blind, placebo-controlled) | HD | Synbiotic (Lactobacillus acidophilus, Bifidobacterium lactis, Inulin)/placebo | Individualized dietary prescription: energy (30–35 kcal/kg/day), protein intake (1.1–1.2 g/kg/day), as well as potassium, phosphorus, and sodium restriction | 22/20 | 8 | 16/16 | 39.84 ± 16.4 | 29.00 ± 6.44 |
| Mazruei et al. (36) | Iran | RCT (double-blind, placebo-controlled) | DN | Probiotic (Bacillus coagulans)/placebo | NA | 30/30 | 12 | NA | 61.5 ± 8.81 | 23.42 ± 5.10 |
| Xie et al. (37) | China | RCT (parallel group, placebo-controlled) | HD | Prebiotic (water soluble fiber, 10 g/day)/placebo | Caloric intake 35 kcal/kg bw, protein intake 1–1.2 g/kg bw, fats <35%, and with sodium and potassium restriction. | 41/44 | 6 | 24/26 | 53.39 ± 13.56 | 30.70 ± 5.10 |
| Prebiotic (water soluble fiber, 20 g/day)/placebo | 39/44 | 16 | 18/26 | 52.44 ± 14.36 | 22.66 ± 2.10 | |||||
| Rossi et al. (15) | Australia | RCT (double-blind, placebo-controlled, crossover) | CKD stage 4–5 | Synbiotic (Lactobacillus, Bifidobacteria, Streptococcus genera, and inulin, fructo-oligosaccharides, and galacto-oligosaccharides)/placebo | NA | 17/20 | 16 | 7/14 | 68.54 ± 9.87 | 22.47 ± 1.97 |
| Khosroshahi et al. (38) | Iran | RCT (double-blind, placebo-controlled) | HD | Prebiotic (HAM-RS2)/placebo | NA | 22/22 | 8 | 12/16 | 56.00 ± 13.08 | 26.25 ± 6.01 |
| Khosroshahi et al. (39) | Iran | RCT (double-blind, placebo-controlled) | HD | Prebiotic (HAM-RS2)/placebo | Not to change usual diets | 23/21 | 8 | 14/15 | 55.43 ± 11.88 | 23.52 ± 2.01 |
| Laffin et al. (40) | Canada | RCT (double-blind, placebo-controlled) | HD | Prebiotic (HAM-RS2)/placebo | NA | 9/11 | 8 | 6/7 | 55.89 ± 10.25 | 24.14 ± 1.93 |
| Mirzaeian et al. (41) | Iran | RCT (double-blind placebo-controlled) | HD | Synbiotic (Lactobacillus, Bifidobacteria, Streptococcus thermophiles, and fructo-oligosaccharides)/placebo | Not to consume foods such as yogurt, cheese, and kefir, which probably contain probiotic strains. | 21/21 | 8 | 14/16 | 64.02 ± 31.5 | 24.72 ± 4.59 |
| Dehghani et al. (42) | Iran | RCT (double-blind placebo-controlled) | CKD stage 3–4 | Synbiotic (Lactobacillus, Bifidobacteria, Streptococcus thermophiles, and fructo-oligosaccharides)/placebo | NA | 31/35 | 6 | 23/27 | 61.41 ± 7.63 | 28.53 ± 4.06 |
I, intervention; C, control; n, number; BMI, body mass index; RCT, randomized controlled trial; DN, diabetic nephropathy; HD, hemodialysis; CKD, chronic kidney disease; APD, automated peritoneal dialysis; NDD-CKD, non-diabetic, non-dialysis-dependent CKD; KTRs, kidney transplant patients; NA, not available.