Objectives
This study was performed to determine the effects of probiotic supplementation on
cholesterol-triglyceride ratio, an indirect marker of insulin resistance, protein-bound
uremic toxins, biomarkers of inflammation, and microbial translocation in end-stage
renal disease patients on hemodialysis.
Methods
Fifty-six patients aged 39–75 years were assigned into two groups to receive either
probiotic sachets (n = 28) or a placebo (n = 28) in a randomized double-blinded placebo-controlled
clinical trial. The patients in the probiotic group received twice daily sachets that
contained a mixture of three viable and freeze-dried strains: Lactococcus lactis subsp. Lactis LL358, Lactobaccillus salivarius LS159, and Lactobaccillus pentosus LPE588 at high dose (100 billion; 1 × 1011 cfu/day) for 6 months.
Results
A total of 50 patients were available for final analysis. Probiotic supplementation
did not have a significant influence on cholesterol-triglyceride ratio. Probiotic
supplementation for 6 months caused a significant decrease in serum levels of indoxyl
sulfate. Compared with the placebo, probiotic supplementation did not result in significant
changes in hemoglobin levels, blood urea nitrogen, blood glucose, serum p-cresyl sulfate, inflammatory, and microbial translocation markers. No clinically
significant changes in body composition were observed between the two groups during
the study period. The probiotic supplementation was well tolerated by all subjects
with minimal adverse effects during the 6-month-long study.
Conclusion
Our results suggest that high-dose multistrain lactobaccillus probiotic supplementation
over 6 months as a monotherapy did not significantly decrease markers of insulin resistance,
cholesterol-triglyceride ratio, and most of the studied markers, with the exception
of levels of indoxyl sulfate in patients on HD.
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Article Info
Publication History
Published online: September 05, 2020
Footnotes
First two authors are of equal contribution
Financial Disclosure: The authors declare that they have no relevant financial interests.
Support: This study was supported by the Ministry of Science and Technology (grant no. MOST 104-2622-E-241-001-CC3 ). The authors are thankful to the New Bellus Enterprise Co., Ltd. (Tainan, Taiwan) for providing us with a sample of Lactobacillus and for sponsoring our study.
Data share: Data described in the manuscript and analytic code will be made available upon request application and approval.
Supplemental Tables 1–5 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/ajcn/.
Clinical Trial Registry number and website: ClinicalTrials.gov (NCT03066921), https://clinicaltrials.gov/ct2/show/NCT03066921?term=NCT03066921&draw=2&rank=1.
The authors express gratitude toward all subjects who participated in the research.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.
