Effects of prebiotics, probiotics and synbiotics on serum creatinine in non-dialysis patients: a meta-analysis of randomized controlled trials

Figures & data

Figure 1. Study flow diagram.

Table 1. Characteristics of Included Studies.

Study, Year	Type of Study	Total sample (case: control)	Sex (M/F)	Mean Age (years)	Intervention	Duration	serum creatinine level after treatment (mg/dL)	related diseases
Firouzi et al. (2015) [15]	Randomized, Controlled parallel trial	136 (68/68)	71/65	53	Probiotic supplement 6 × 10^10colony-forming unit (CFU)/d	12 weeks	Intervention Group: 0.82 ± 0.22 Control Group: 0.85 ± 0.21	Diabetes
Dehghani et al. (2016) [16]	Randomized, Controlled parallel trial	66 (31/35)	50/16	61	Synbiotics supplement, 1000 mg/d	6 weeks	Intervention Group: 1.90 ± 0.70 Control Group: 2.18 ± 1.14	Kidney disease
Rossi et al. (2016) [17]	Randomized, Controlled crossover trial	31 31/31)	21/10	69	Synbiotics supplement The first 3 weeks, 7.5 g placebo/prebiotic powder and one placebo/probiotic capsule containing 4.5 × 10^10 CFU. After the dose escalation, 15 g and 9 × 10^10CFU/d for 6 weeks	9 weeks	Intervention Group: 2.61 ± 0.85 Control Group: 2.64 ± 0.84	Kidney disease
Abbasi et al. (2017) [18]	Randomized, controlled parallel trial	40 (20/20)	NA	55	Probiotic supplement 4 × 10^9 CFU/d	8 weeks	Intervention Group: 0.83 ± 0.16 Control Group: 1.00 ± 0.14	Kidney disease
Ebrahimi et al. (2017) [19]	Randomized, controlled parallel trial	70 (35/35)	42/28	59	Synbiotics supplement 500 mg/d	9 weeks	Intervention Group: 1.05 ± 0.26 Control Group: 1.03 ± 0.24	Diabetes
Harata et al. (2017) [20]	Randomized, controlled parallel trial	25 (14/11)	9/16	37	Probiotic supplement	10 weeks	Intervention Group (SE): 0.7 ± 0.2 Control Group (SE): 0.7 ± 0.2	Cedar pollinosis patients
Tuncay et al. (2018) [21]	Randomized, controlled parallel trial	46 (23/23)	23/23	71.8	Prebiotic supplemen	3 weeks	Intervention Group: 1.23 ± 0.84 Control Group: 0.77 ± 0.37	Neurocritical care patients
Ramos et al. (2019) [22]	Randomized, controlled parallel trial	46 (23/23)	27/19	57	Prebiotic supplement 12g/d	3 months	Change of intervention Group (Range): (−0.2 to 0.3) Change of control Group (Range): 0.0 (−0.1 to 0.3)	Kidney disease
Romão et al. (2020) [23]	Randomized, controlled parallel trial	36 (19/17)	0/36	43	Probiotic supplement 4 × 10^9 CFU/d	8 weeks	Intervention Group (95% CI): 0.65 (0.56–0.73) Control Group (95% CI): 0.58 (0.52–0.63)	Hypertension
Cosola et al. (2021) [24]	Randomized, controlled parallel trial	n = 23 (13/10)	14/9	51	Synbiotics supplement probiotics 9.6 × 10^9 CFU/d prebiotics 10 g/d	2 months	intervention Group (SE): 2.3 ± 0.2 control Group (SE): 3.1 ± 0.4	Kidney disease
Armani et al. (2021) [25]	Randomized, controlled parallel trial	46 (23/23)	24/22	57.6	Prebiotic supplement 12g/d	3 months	Intervention Group (Range): 2.96 (2.00–3.53) Control Group (Range): 2.83 (2.34–3.75)	Kidney disease
McFarlane et al. (2021) [26]	Randomized, controlled parallel trial	56 (28/28)	NA	70	Synbiotics supplement The first 2 weeks, prebiotic 10 g /d, probiotic 4.5 × 10^11 CFU/d. Prebioti 20 g /d, probiotic 4.5 × 10^11 CFU/d for 50 weeks.	52 weeks.	Change of intervention Group (95%CI): 0.24 (0.03–0.44) Change of control Group (95%CI): −0.11 (−0.25–0.02)	Kidney disease

Data are presented as means ± SD, means ± SE, means (Range), means (95% CI); CI: confidence interval; M: male; F: female; NA: not available.

Figure 2. Meta-analysis for prebiotics, probiotics and synbiotics on serum creatinine in non-dialysis patients.

Figure 3. Effects of different types of interventions on serum creatinine. (A) Effects of probiotics on serum creatinine. (B) Effects of prebiotics on serum creatinine. (C) Effects of synbiotics on serum creatinine.

Figure 4. Effects of different treatment duration on serum creatinine. (A) Effects of treatment duration 2 months or less on serum creatinine. (B) Effects of treatment duration longer than 2 months on serum creatinine.

Figure 5. Meta-analysis of randomized controlled parallel trials for prebiotics, probiotics and synbiotics on serum creatinine in non-dialysis patients.

Figure 6. Meta-analysis for prebiotics, probiotics and synbiotics on serum creatinine in non-dialysis kidney disease patients. (A) Effects of of prebiotics, probiotics and synbiotics on serum creatinine in kidney disease patients. (B) Effects of of synbiotics on serum creatinine in kidney disease patients. (C) Effects of treatment duration longer than 2 months on serum creatinine in kidney disease patients.

Figure 7. Funnel plots of the meta-analysis for prebiotics, probiotics and synbiotics on serum creatinine levels.

Figure 8. Risk of bias assessment for included RCTs. (A) Risk of bias summary. (B) Risk of bias graph. Green indicated low risk of bias, yellow for some concerns of bias and red for high risk of bias.

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Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.