Cochrane · systematic review · CD013631
Synbiotics, prebiotics and probiotics for people with chronic kidney disease
Cooper, TE, Khalid, R, Chan, S, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
Kidney and TransplantAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
87
current version
GRADE rated
34
No studies
40
Included studies
NR
No studies 40 · 46%Ungraded 13 · 14.9%Very low 33 · 37.9%Low 1 · 1.1%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Synbiotic versus another synbiotic for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Albuminuria or proteinuria Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Indoxyl sulfate Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Change in any GI upset or intolerance Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Microbiota composition Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Graft function Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Graft infection Synbiotic vs another synbiotic | no estimate extracted | NR | No studies |
Synbiotic versus prebiotic for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR (mL/min) Synbiotic vs prebiotic | no estimate extracted | 1 study · 34 participants | Very low Downgraded: risk of bias |
Albuminuria or proteinuria Synbiotic vs prebiotic | no estimate extracted | NR | No studies |
Indoxyl sulfate (ng/mL) Synbiotic vs prebiotic | no estimate extracted | 1 study · 42 participants | Very low Downgraded: risk of bias |
Change in any GI upset (borborygmi) Synbiotic vs prebiotic | RR 15.26 [0.99, 236.23] | 1 study · 34 participants | Very low Downgraded: risk of bias |
Change in any GI upset (GSRS total index) Synbiotic vs prebiotic | no estimate extracted | 1 study · 56 participants | Very low Downgraded: risk of bias |
Microbiota composition Synbiotic vs prebiotic | no estimate extracted | NR | No studies |
Graft function Synbiotic vs prebiotic | no estimate extracted | NR | No studies |
Graft infection Synbiotic vs prebiotic | no estimate extracted | NR | No studies |
Prebiotic versus another prebiotic for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR (mL/min) Prebiotic vs another prebiotic | no estimate extracted | 1 study · 50 participants | Very low Downgraded: risk of bias |
Albuminuria or proteinuria Prebiotic vs another prebiotic | no estimate extracted | NR | No studies |
Indoxyl sulfate (μg/mL) Prebiotic vs another prebiotic | no estimate extracted | 2 studies · 64 participants | Very low Downgraded: risk of bias |
Change in any GI upset or intolerance Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Burping Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Cramping Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Distension Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Flatulence Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Nausea Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Reflux Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Rumblings Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Very low Downgraded: risk of bias |
Microbiota composition Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Actinobacteria Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Bacteriodetes Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Proteobacteria Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Firmicutes Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Synergistetes Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Verrucomicrobia Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Faecal acetate Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Faecal propionate Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Faecal butyrate Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Faecal total short‐chain fatty acids Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Faecal indoles Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Faecal P‐cresol Prebiotic vs another prebiotic | no estimate extracted | 1 study · 24 participants | Ungraded |
Graft function Prebiotic vs another prebiotic | no estimate extracted | NR | No studies |
Graft infection Prebiotic vs another prebiotic | no estimate extracted | NR | No studies |
Prebiotic versus probiotic for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Albuminuria or proteinuria Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Indoxyl sulfate Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Change in any GI upset or intolerance Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Microbiota composition Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Graft function Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Graft infection Prebiotic vs probiotic | no estimate extracted | NR | No studies |
Probiotic versus another probiotic for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR (mL/min) Probiotic vs another probiotic | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias |
Albuminuria or proteinuria Probiotic vs another probiotic | no estimate extracted | NR | No studies |
Indoxyl sulfate Probiotic vs another probiotic | no estimate extracted | NR | No studies |
Change in any GI upset or intolerance Probiotic vs another probiotic | no estimate extracted | NR | No studies |
Microbiota composition Probiotic vs another probiotic | no estimate extracted | NR | No studies |
Graft function Probiotic vs another probiotic | no estimate extracted | NR | No studies |
Graft infection Probiotic vs another probiotic | no estimate extracted | NR | No studies |
Synbiotic versus placebo or no treatment for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR (mL/min) Synbiotic vs placebo or no treatment | no estimate extracted | 2 studies · 98 participants | Very low Downgraded: risk of bias |
Albuminuria or proteinuria Synbiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Indoxyl sulfate Synbiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Change in any GI upset or intolerance (GSRS) Synbiotic vs placebo or no treatment | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias |
Rumbling Synbiotic vs placebo or no treatment | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias |
Hard stools Synbiotic vs placebo or no treatment | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias |
Abdominal pain Synbiotic vs placebo or no treatment | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias |
Constipation syndrome Synbiotic vs placebo or no treatment | no estimate extracted | 1 study · 23 participants | Very low Downgraded: risk of bias |
Microbiota composition Synbiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Graft function Synbiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Graft infection Synbiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Prebiotic versus placebo or no treatment for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR Prebiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Albuminuria or proteinuria Prebiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Indoxyl sulfate (mg/L) Prebiotic vs placebo or no treatment | no estimate extracted | 2 studies · 75 participants | Very low Downgraded: risk of bias |
Any change in GI upset or intolerance Prebiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Microbiota composition Prebiotic vs placebo or no treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Faecalibacterium Prebiotic vs placebo or no treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Parabacteroides Prebiotic vs placebo or no treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Bifidobacteria Prebiotic vs placebo or no treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Ruminococcus Prebiotic vs placebo or no treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Prevotella Prebiotic vs placebo or no treatment | no estimate extracted | 1 study · 44 participants | Very low Downgraded: risk of bias |
Graft function Prebiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Graft infection Prebiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Probiotic versus placebo or no treatment for people with chronic kidney disease
Population: people with CKD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
eGFR (mL/min) Probiotic vs placebo or no treatment | no estimate extracted | 1 study · 40 participants | Very low Downgraded: risk of bias |
Albuminuria (g/dL) Probiotic vs placebo or no treatment | no estimate extracted | 1 study · 33 participants | Low Downgraded: risk of bias |
Proteinuria (mg/dL) Probiotic vs placebo or no treatment | no estimate extracted | 1 study · 60 participants | Very low Downgraded: risk of bias |
Indoxyl sulfate (mg/dL) Probiotic vs placebo or no treatment | no estimate extracted | 1 study · 33 participants | Very low Downgraded: risk of bias |
Change in any GI upset or intolerance (abdominal pain/diarrhoea) Probiotic vs placebo or no treatment | RR 2.13 [0.21, 21.22] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Change in any GI upset or intolerance (constipation) Probiotic vs placebo or no treatment | RR 3.18 [0.14, 72.75] | 1 study · 33 participants | Very low Downgraded: risk of bias |
Microbiota composition Probiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Graft function Probiotic vs placebo or no treatment | no estimate extracted | NR | No studies |
Graft infection Probiotic vs placebo or no treatment | no estimate extracted | NR | No studies |