MO563: Effect of Probiotics on Uremic Toxins Production and Inflammation in Patients Suffering from CKD Stage 3 and 4

Abstract

Abstract BACKGROUND AND AIMS Probiotics are being coprescribed in the management of chronic kidney disease (CKD). Few studies have reported that probiotics could slow down the progression of CKD by regulating the intestinal flora and by reducing the uremic toxins. [1,2] Objective of our study is to assess the effect of probiotics on uremic toxins production and inflammation in patient suffering from CKD stage 3 and 4. METHOD Patients of either sex, aged 18–75 years, suffering from CKD stage 3 and 4 were enrolled. Study was conducted at Department of Nephrology, Guwahati Medical College and Hospital (GMCH), Guwahati, Assam. Patients received 1 capsule containing 45 billion of colony forming units of probiotics twice a day for 180 days. Patients were evaluated at day 0, 90 and 180. Parameters such as serum creatinine, blood urea, uric acid, C-reactive protein (CRP), hemoglobin and albumin were recorded at each visit. RESULTS During period of May 2019 to May 2020, 102 patients were enrolled and followed for 180 days. Significantly higher number of males 67 (66%) than 35 (34%) females is reported (P = 0.024). CKD stage 3 and 4 is reported in 41 (40% ) and 61 (60%), respectively. Insignificant drop of serum creatinine of -0.17 (on day 90, P = 0.146) and -0.23 (on day 180, P = 0.135) compared with baseline Sr. creatinine 2.53 ± 0.56 (mean ± SD) is reported. Significant drop in blood urea is reported on day 90 (-2.97, P = 0.014) and on day 180 (-3.60, P < 0.001) compared with baseline 52.11 ± 26.90 (mean ± SD). The reduction in CRP on day 90 and day 180 from baseline was found to be statistically significant (P = 0.037, 0.011). However, reduction in uric acid and increase in hemoglobin and albumin did not reach significance on day 90 and day 180. CONCLUSION Probiotics supplementation lead to decrease in blood urea and CRP. However, its effect on serum creatinine, hemoglobin, uric acid and albumin did not reach statistical significance. More randomized controlled trials are required to prove the efficacy of probiotics to retard CKD progression.