Probiotic Supplementation in Chronic Kidney Disease: Outcomes on Uremic Toxins, Inflammation, and Vascular Calcification from Experimental and Clinical Models.

Probiotic supplementation reduced levels of interleukin-6 (IL-6) and interferon-γ (IFN-γ) in the experimental rat model of CKD with vascular calcification.

• The experimental model used 5/6 nephrectomy (Nx), a high-phosphate diet, and calcitriol to induce CKD and vascular calcification.
• Animals were divided into three groups: Sham, Nephrectomy, and Nephrectomy + Probiotic.
• The probiotic used was a commercial product called Probimel.
• Reduction in pro-inflammatory cytokines IL-6 and IFN-γ was observed in the Nephrectomy + Probiotic group.

Probiotic supplementation decreased levels of the uremic toxin indoxyl sulfate (IS) in the experimental rat model.

• Indoxyl sulfate is a gut-derived uremic toxin associated with CKD progression and inflammation.
• The reduction in IS was observed in the Nephrectomy + Probiotic group compared to the Nephrectomy group.
• The experimental model involved 5/6 nephrectomy combined with a high-phosphate diet and calcitriol administration.

Probiotic supplementation did not produce clear evidence of improvement in kidney function in either the experimental rat model or in patients with advanced CKD.

• Kidney function was evaluated in both the rat model and the clinical study.
• The clinical study included 23 patients with advanced stage 5 CKD and vascular calcification.
• Patients were randomized to receive or not receive daily probiotics for 6 months.
• No significant improvement in kidney function parameters was observed under the experimental and clinical conditions studied.

Probiotic supplementation did not demonstrate clear improvement in vascular calcification in either the rat model or in patients with advanced CKD.

• Vascular calcification was evaluated in both the experimental and clinical components of the study.
• The clinical study enrolled 23 patients with stage 5 CKD who already had vascular calcification at baseline.
• Patients received daily probiotic supplementation (Probimel) for 6 months.
• The selected probiotic did not modify key parameters related to vascular calcification under the experimental and clinical conditions studied.

The selected probiotic did not modify key parameters related to CKD progression or vascular calcification in either the experimental or clinical model.

• Parameters evaluated included kidney function, mineral metabolism, uremic toxins, inflammation, vascular calcification, and fecal microbiota.
• The clinical study was an exploratory randomized study with 23 patients over 6 months.
• The experimental model used 5/6 nephrectomy with high-phosphate diet and calcitriol.
• The authors concluded that 'the selected probiotic did not modify key parameters related to CKD progression or VC' under the conditions studied.

CKD is associated with gut microbiota alterations that contribute to increased inflammation and generation of uremic toxins, potentially worsening disease progression.

• Gut microbiota dysbiosis in CKD is linked to increased pro-inflammatory cytokine profiles.
• Uremic toxins generated through gut microbiota activity include indoxyl sulfate.
• The effects of probiotics on mineral metabolism, vascular calcification, and CKD progression were identified as unclear prior to this study.
• Probiotics were noted to potentially improve the pro-inflammatory cytokine profile in CKD.