Efficasy of probiotics (saccharomyces billiards) on uremic toxins and quality of life of chronic hemodialysis patients

Abstract

Introduction: The role of the intestinal microbiota in human health and their relation to chronic kidney disease (CKD) progression has well been established. Changing the dominant intestinal bacterial phyla into the pathogenic forms in CKD patients leads to the increased production of uremic toxins. Aim: The aim of this study was to investigate the effect of probiotic (Saccharomyces Boulardii) supplementation on serum concentration of IS and quality of life of chronic hemodialysis patients. Methods: This study was performed as a randomized clinical trial without a control group in the hemodialysis ward of Amir Al-Momenin Hospital and Sina Hospital from the beginning of July 2019 to the end of February 2020. Forty five patients were included into the study and received one probiotic capsule (Dailyeast®) daily for 4 months. Serum concentration of IS was measured before and after the supplementation period. Similarly, SF-36 form was completed by each patient to assess his/her QoL at the initiation and end of the study. The values of IS concentration as well as SF-36 score at the baseline were compared with those obtained at the study termination. Results: There was a significant decrease in serum level of IS after probiotic supplementation. Also a marked improvement was obsereved in overall (p=0.032), mental component (p=0.003) and physical component (p<0.01) of QoL in studied patients. However, no relationship was shown between improvement of QoL and reduction of IS serum concentration.

Conclusion: Supplemental use of Probiotic Saccharomyces Boulardii significantly reduced serum level of IS and produced marked improvement in mental and physical components of QoL in hemodialysis patients.