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Influence of prebiotic and probiotic supplementation on the progression of chronic kidney disease.

BACKGROUND
One of the main goals in chronic kidney disease (CKD) patients is to diminish the accumulation of uremic toxins and to slow the progression of renal failure. We investigated whether prebiotic and probiotic supplementation along with low protein diet retards the progression of CKD.


METHODS
This is a 12-month prospective observation study with a randomized control and open-label design. A total of 24 stable CKD stage III to V patients, who are not on renal replacement therapy, were enrolled in this study. Patients were randomly assigned to 2 groups: low protein diet + prebiotic + probiotic supplementation (N.=12), receiving 3 tablets of prebiotic + probiotic supplementation daily for 6 months, and the control group receiving low protein diet only (N.=12). We examined the effects of prebiotic and probiotic supplementation on estimated glomerular filtration rate (eGFR) in CKD.


RESULTS
The declining GFR during prebiotic and probiotic supplementation were significantly lower (-11.6±8.6 vs. -3.4±4.6 mL/min per 1.73 m2 per year, 95% CI -6.45 - -9.86, P<0.001) than those with low protein diet alone.


CONCLUSIONS
Prebiotic and probiotic supplementation along with low protein diet delayed the progression of CKD.