Pre-, pro-, and synbiotics: do they have a role in reducing uremic toxins? A systematic review and meta-analysis

Rossi, Megan, Klein, Kerenaftali, Johnson, David W. and Campbell, Katrina L. (2012) Pre-, pro-, and synbiotics: do they have a role in reducing uremic toxins? A systematic review and meta-analysis. International Journal of Nephrology, 2012 673631.1-673631.20. doi:10.1155/2012/673631

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Author Rossi, Megan
Klein, Kerenaftali
Johnson, David W.
Campbell, Katrina L.
Title Pre-, pro-, and synbiotics: do they have a role in reducing uremic toxins? A systematic review and meta-analysis
Journal name International Journal of Nephrology   Check publisher's open access policy
ISSN 2090-214X
2090-2158
Publication date 2012-12-21
Sub-type Article (original research)
DOI 10.1155/2012/673631
Open Access Status DOI
Volume 2012
Start page 673631.1
End page 673631.20
Total pages 20
Place of publication New York, NY, United States
Publisher Hindawi
Language eng
Formatted abstract
Objective: This paper assessed the effectiveness of pre-, pro-, and synbiotics on reducing two protein-bound uremic toxins, p-cresyl sulphate (PCS) and indoxyl sulphate (IS).

Methods: English language studies reporting serum, urinary, or fecal PCS and/or IS (or their precursors) following pre-, pro-, or synbiotic interventions (>1 day) in human adults were included. Population estimates of differences in the outcomes between the pre- and the postintervention were estimated for subgroups of studies using four meta-analyses. Quality was determined using the GRADE approach.

Results: 19 studies met the inclusion criteria, 14 in healthy adults and five in haemodialysis patients. Eight studies investigated prebiotics, six probiotics, one synbiotics, one both pre- and probiotics, and three studies trialled all three interventions. The quality of the studies ranged from moderate to very low. 12 studies were included in the meta-analyses with all four meta-analyses reporting statistically significant reductions in IS and PCS with pre- and probiotic therapy.

Conclusion: There is a limited but supportive evidence for the effectiveness of pre- and probiotics on reducing PCS and IS in the chronic kidney disease population. Further studies are needed to provide more definitive findings before routine clinical use can be recommended.
Keyword Prebiotics
Probiotics
Synbiotics
Systematic review
Uremic toxins
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article ID 673631

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
School of Medicine Publications
 
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Created: Wed, 02 Jan 2013, 23:02:13 EST by Kere Klein on behalf of School of Public Health