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dc.contributor.authorMcFarlane, C
dc.contributor.authorRamos, CI
dc.contributor.authorJohnson, DW
dc.contributor.authorCampbell, KL
dc.date.accessioned2019-06-10T01:32:53Z
dc.date.available2019-06-10T01:32:53Z
dc.date.issued2019
dc.identifier.issn1051-2276
dc.identifier.doi10.1053/j.jrn.2018.08.008
dc.identifier.urihttp://hdl.handle.net/10072/384077
dc.description.abstractObjective: Gut dysbiosis has been implicated in the pathogenesis of chronic kidney disease (CKD). Restoring gut microbiota with prebiotic, probiotic, and synbiotic supplementation has emerged as a potential therapeutic intervention but has not been systematically evaluated in the CKD population. Design and Methods: This is a systematic review. A structured search of MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and the International Clinical Trials Register Search Portal was conducted for articles published since inception until July 2017. Included studies were randomized controlled trials investigating the effects of prebiotic, probiotic, and/or synbiotic supplementation (>1 week) on uremic toxins, microbiota profile, and clinical and patient-centered outcomes in adults and children with CKD. Results: Sixteen studies investigating 645 adults met the inclusion criteria; 5 investigated prebiotics, 6 probiotics, and 5 synbiotics. The quality of the studies (Grades of Recommendation, Assessment, Development and Evaluation) ranged from moderate to very low. Prebiotic, probiotic, and synbiotic supplementation may have led to little or no difference in serum urea (9 studies, 345 participants: mean difference [MD] −0.30 mmol/L, 95% confidence interval [CI] −2.20 to 1.61, P =.76, I2 = 53%), indoxyl sulfate (4 studies, 144 participants: MD −0.02 mg/dL, 95% CI −0.09 to 0.05, P =.61, I2 = 0%), and p-cresyl sulfate (4 studies, 144 participants: MD −0.13 mg/dL, 95% CI −0.41 to 0.15, P =.35, I2 = 0%). Prebiotic supplementation may have slightly reduced serum urea concentration (4 studies, 105 participants: MD −2.23 mmol/L, 95% CI −3.83 to −0.64, P =.006, I2 = 11). Of the 2 studies investigating microbiota changes, synbiotic interventions significantly increased Bifidobacterium. Supplement effects on clinical outcomes were uncertain. Conclusions: There is limited evidence to support the use of prebiotics, probiotics, and/or synbiotics in CKD management.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.relation.ispartofpagefrom209
dc.relation.ispartofpageto220
dc.relation.ispartofissue3
dc.relation.ispartofjournalJournal of Renal Nutrition
dc.relation.ispartofvolume29
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchNutrition and dietetics
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode3210
dc.titlePrebiotic, Probiotic, and Synbiotic Supplementation in Chronic Kidney Disease: A Systematic Review and Meta-analysis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.rights.copyright© 2018 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorCampbell, Katrina


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