Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis

Introduction. Dysbiosis microbiota is considered as one of the consequences and impacts of high uremic toxins in patients with Chronic Kidney Disease (CKD), which can lead to an increased risk of progression and mortality. The aim of this systematic review and meta-analysis was to perform quantitati...

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Main Authors: Burhan Gunawan, Raymond Sebastian Purwata, Syarif Hidayat, Roy Akur Pandapotan, Jennifer
Format: Article
Language:Indonesian
Published: Department of Internal Medicine, Faculty of Medicine Universitas Indonesia 2023-03-01
Series:Jurnal Penyakit Dalam Indonesia
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Online Access:https://scholarhub.ui.ac.id/jpdi/vol10/iss1/5/
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author Burhan Gunawan
Raymond Sebastian Purwata
Syarif Hidayat
Roy Akur Pandapotan
Jennifer
author_facet Burhan Gunawan
Raymond Sebastian Purwata
Syarif Hidayat
Roy Akur Pandapotan
Jennifer
author_sort Burhan Gunawan
collection DOAJ
description Introduction. Dysbiosis microbiota is considered as one of the consequences and impacts of high uremic toxins in patients with Chronic Kidney Disease (CKD), which can lead to an increased risk of progression and mortality. The aim of this systematic review and meta-analysis was to perform quantitative effect of microbiota modulation for estimated Glomerular Filtration Rate (eGFR), uremic toxin (total-p cresyl/total pCS), and inflammatory marker (hs-CRP) outcome among CKD patients. Methods. Article searches were conducted from PubMed, ScienceDirect, and Cochrane Library data sources from 2010-2022. Assessment of article quality follows the rules of PRISMA (Preferred Reporting Items in Systematic Review and Meta-Analysis). Only randomized controlled trial (RCT) articles investigating the effect of symbiotic, prebiotic, of probiotic for CKD were included in the analysis. Effect size quantify from Standardized Mean Difference (SMD), using a continuous random effect model and described in the forest plot model. Results. A total of 17 RCT studies with a total 867 CKD stage 1-5 subjects (440 subjects in the intervention group and 427 subjects in the control group). The intervention duration ranging from 1-12 months. The studies included had varied on methodologies, with significant heterogenicity (I296,96%, p Conclusions. The administration of probiotic/prebiotic/symbiotic supplements to CKD patients resulted in significant improvements in e-GFR and reductions in total pCS. These results suggest the potential of symbiotic, prebiotic, and probiotic supplementation to improve CKD outcome.
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spelling doaj-art-cf6980dfd5fd425ab9dd2403e64762a62025-08-20T02:01:09ZindDepartment of Internal Medicine, Faculty of Medicine Universitas IndonesiaJurnal Penyakit Dalam Indonesia2406-89692549-06212023-03-011012532https://doi.org/10.7454/jpdi.v10i1.1036Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-AnalysisBurhan Gunawan0Raymond Sebastian Purwata 1Syarif Hidayat 2Roy Akur Pandapotan 3Jennifer 4Divisi Ilmu Penyakit Dalam, Rumah Sakit Sumber Waras, Jakarta Barat, IndonesiaDivisi Ilmu Penyakit Dalam, Rumah Sakit Sumber Waras, Jakarta Barat, Indonesia Divisi Ilmu Penyakit Dalam, Rumah Sakit Sumber Waras, Jakarta Barat, IndonesiaDivisi Ilmu Penyakit Dalam, Rumah Sakit Sumber Waras, Jakarta Barat, Indonesia Divisi Ilmu Penyakit Dalam, Rumah Sakit Sumber Waras, Jakarta Barat, IndonesiaIntroduction. Dysbiosis microbiota is considered as one of the consequences and impacts of high uremic toxins in patients with Chronic Kidney Disease (CKD), which can lead to an increased risk of progression and mortality. The aim of this systematic review and meta-analysis was to perform quantitative effect of microbiota modulation for estimated Glomerular Filtration Rate (eGFR), uremic toxin (total-p cresyl/total pCS), and inflammatory marker (hs-CRP) outcome among CKD patients. Methods. Article searches were conducted from PubMed, ScienceDirect, and Cochrane Library data sources from 2010-2022. Assessment of article quality follows the rules of PRISMA (Preferred Reporting Items in Systematic Review and Meta-Analysis). Only randomized controlled trial (RCT) articles investigating the effect of symbiotic, prebiotic, of probiotic for CKD were included in the analysis. Effect size quantify from Standardized Mean Difference (SMD), using a continuous random effect model and described in the forest plot model. Results. A total of 17 RCT studies with a total 867 CKD stage 1-5 subjects (440 subjects in the intervention group and 427 subjects in the control group). The intervention duration ranging from 1-12 months. The studies included had varied on methodologies, with significant heterogenicity (I296,96%, p Conclusions. The administration of probiotic/prebiotic/symbiotic supplements to CKD patients resulted in significant improvements in e-GFR and reductions in total pCS. These results suggest the potential of symbiotic, prebiotic, and probiotic supplementation to improve CKD outcome.https://scholarhub.ui.ac.id/jpdi/vol10/iss1/5/chronic kidney diseasee-gfrhs-crpprebioticprobioticuremic toxin
spellingShingle Burhan Gunawan
Raymond Sebastian Purwata
Syarif Hidayat
Roy Akur Pandapotan
Jennifer
Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis
Jurnal Penyakit Dalam Indonesia
chronic kidney disease
e-gfr
hs-crp
prebiotic
probiotic
uremic toxin
title Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis
title_full Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis
title_fullStr Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis
title_full_unstemmed Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis
title_short Microbiota Modulation to Improve estimated Glomerular Filtration Rate, Uremic Toxins, and Inflammatory Marker in Chronic Kidney Disease: Systematic Review and Meta-Analysis
title_sort microbiota modulation to improve estimated glomerular filtration rate uremic toxins and inflammatory marker in chronic kidney disease systematic review and meta analysis
topic chronic kidney disease
e-gfr
hs-crp
prebiotic
probiotic
uremic toxin
url https://scholarhub.ui.ac.id/jpdi/vol10/iss1/5/
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