The beneficial effects of probiotics in peritoneal dialysis patients.

China Medical University Hospital

Title: The beneficial effects of probiotics in peritoneal dialysis patients.

I-Kuan Wang1,2_{, Ya-Fei Yang}2_{, I-Wen Ting}2_{, Chung-Chih Lin}2_{, Yao-Lung Liu}2_{, Che-Yi Chou}2_{, Jiung-Hsiun}

Liu2_{, Shih-Yi Lin}2_{, Hung-Chih Lin}3_{, and Chiu-Ching Huang}2

1_{Graduate institute of clinical medical science, College of medicine, China medical University,} 2_{Division of}

nephrology, China medical university hospital, 3Deparment of pediatrics, China medical university hospital.

Background

Inflammatory markers such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) are elevated in dialysis patients and can predict cardiovascular events and all-cause mortality. Endotoxin is an important source and another marker of inflammation in patients with chronic kidney disease. The aim of this study was to evaluate the impact of oral probiotics on serum levels of cytokines and endotoxemia in peritoneal dialysis (PD) patients.

Materials and methods

From March 2011 to June 2012, a randomized, double-blind, placebo-controlled trial was conducted in PD patients at China Medical University Hospital. After obtaining informed consent, the intervention group received probiotics containing 109 _{colony-forming units (CFU) B. bifidum A218, 10}9 _{CFU B. catenulatum}

A302, 109 _{CFU B. longum A101, and 10}9 _{CFU L. plantarum A87 daily for six months, while the placebo group}

received similar capsules containing maltodextrin for the same duration. Levels of serum TNF-α, INF-γ, IL-5, IL-6, IL-10, IL-17, and endotoxin were measured before and six months after intervention.

Results

Thirty-nine patients completed the study (21 in the probiotics group and 18 in the placebo group). In patients receiving probiotics, levels of serum TNF-α, IL-5, IL-6, and endotoxin significantly decreased after six months of treatment, while levels of serum IL-10 significantly increased. In contrast, there were no significant changes in levels of serum cytokines and endotoxin in the placebo group after six months.

Conclusions

Probiotics could significantly reduce the serum levels of endotoxin, pro-inflammatory cytokines (TNF-α and IL-6), IL-5, and increase the serum levels of anti-inflammatory cytokine (IL-10) in PD patients.

Patients included in this study.

The distribution of serum levels of cytokines and endotoxin in

peritoneal dialysis patients before and after treatment.