Daily probiotics show benefits for patients on peritoneal dialysis
Patients on peritoneal dialysis who received daily probiotic supplementation saw improvements in measures related to malnutrition and health-related quality of life, according to results of a randomized controlled trial conducted in China.
“Alterations in the gut microbiota and host responses have been implicated in the progression of end-stage renal disease, increased cardiovascular risk, uremic toxicity, and inflammation,” Yangbin Pan, MD, PhD, of Shanghai Pudong Hospital at Fudan University Pudong Medical Center, and colleagues wrote.
They suggested that while several studies have demonstrated beneficial effects in a variety of clinical settings, including for patients undergoing hemodialysis or with chronic kidney disease stages 3 to 4, there remains a lack of data on whether probiotics improve the quality of life of patients undergoing peritoneal dialysis (PD).
To address this gap in the literature, as well as to look specifically at the impact of probiotics on malnutrition, the researchers randomized 116 patients on PD to either control or an intervention with supplementation. The intervention group received a daily dose of probiotics for 2 months.
Blood samples, obtained from each patient at baseline at 2 months, were reviewed with researchers considering serum creatinine, blood urea nitrogen, hemoglobin (Hb), albumin (Alb), high-sensitivity C-reactive protein (hs-CRP), IL-6, total triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol.
Results showed high-sensitivity C-reactive protein, IL-6 and LDL-C values were lower for patients taking probiotics vs. control, with the levels of high-sensitivity C-reactive protein and interleukin-6 decreasing after 2 months of supplementation and the serum albumin levels, upper arm circumference and triceps skinfold thickness increasing.
Regarding health-related quality of life, responses to the short-form health survey (SF-36) questionnaire demonstrated the value of physical functioning was higher in the probiotic group than in the control group after 2 months (75 vs. 64.48). The value of social functioning was also higher in the probiotic group (60 vs. 53.08).
Pan and colleagues elaborated on these results, writing: “Although our data did not show a significant difference between baseline and 2 months regarding the physical component scale or the mental component scale of the SF-36, the index of physical functioning and social functioning improved markedly in the probiotics group but not in the control group.”
These higher reported quality of life measures accompanying probiotic supplementation could be a response to improved nutritional status and decreased inflammatory mediators, according to the researchers.
“This investigation highlights the need for larger-scale research to confirm the benefits of probiotics in patients undergoing PD,” they concluded.