Protective Effect of Probiotic Against Progression of Chronic Kidney Disease: A Randomized Clinical Study

Abstract

Background: Chronic kidney disease (CKD) is a gradual, irreversible disease with severe global health implications. By raising the level of urea toxins in the body, gut microbiota dysbiosis may hasten the onset of chronic renal disease. Probiotics have been recognized to keep the intestinal microbiota’s physiological equilibrium. In an effort to develop alternatives to chronic hemodialysis, much research has been carried out, especially for elderly patients who face psychological challenges. Objectives: The goal of this study is to assess the therapeutic benefits of probiotics on CKD patients. Materials and Methods: This randomized clinical trial was carried out at the Dialysis Center of Al-Diwaniyah Medical Hospital in Diwaniyah Governorate. Forty-two patients with end-stage renal disease on regular hemodialysis were enrolled, with 21 patients receiving oral probiotic supplementation in addition to standard care, and 21 patients receiving only standard care. Blood samples were collected at the baseline and after eight weeks, and several biomarkers were measured, including estimated glomerular filtration rate, creatinine, urea, phosphorus, albumin, and indoxyl sulfate. Results: The results showed that there was a significant difference in the mean difference of blood urea (P = 0.008) and serum phosphorus (P = 0.004) among groups, and the significant level was attributed to the probiotic group. However, the other biomarkers were not affected by the treatment. Conclusion: The use of oral probiotics for 8 weeks in Iraqi patients on hemodialysis can improve urea and phosphorus levels and safeguard the intestinal epithelial barrier in CKD patients.