How Probiotics Can Help Chronic Renal Failure Patients

Health Benefits of Probiotics

There is evidence that some foods can positively affect human health beyond just providing nutrition. These “functional foods” foods could help prevent or treat diseases. Probiotics, prebiotics, and symbiotics are all types of functional foods.

Probiotics can provide health benefits when consumed appropriately by improving resistance to pathogens (organisms that cause diseases) in the body and creating a balance in the ecosystem of microorganisms in the gut.

Imbalance in Renal Disease Patients

About two-thirds of renal disease patients are likely to have an imbalance in the microbes living in the gastrointestinal mucosa (the lining of the stomach and intestines). This imbalance usually results from an increase in aerobic bacteria that produce toxins and a decrease in the number of anaerobic bacteria, such as bifidobacteria and lactobacillus. In patients with chronic renal failure (CRF), there are greater urea concentrations and, consequently, increased ammonium. Thus, there is an increase in the potential of hydrogen (pH) that allows aerobic bacteria to grow more, leading to the production of harmful toxins. Bifidobacteria, when used as probiotics, ferment carbohydrates and produce acids that prevent the growth of aerobic microorganisms and thus, keep the intestines healthy.

How Probiotics May Remove Toxins from the Blood

One of the requirements for using probiotics to remove urea or toxins from the blood is that the probiotics can use metabolites as food, decreasing bacteria that produce uremic toxins. The urease enzyme breaks down urea into ammonia and carbon dioxide. Only certain types of bacteria can produce this enzyme. In patients with uremia (buildup of toxins in the blood), it has been shown that at high levels of plasma urea, there is an increase in urease which is a good thing for these patients. 

One bacteria that can produce urease is Lactobacillus casei Shirota (LcS). It is used to make fermented dairy products. It has been shown to have many benefits: modulating the intestinal flora, protecting against infection, and modulating the immune system, among others.

This study aimed to determine the LcS dose that would benefit at least a 10% decrease in the blood urea concentration for patients with stages 3 and 4. The hypothesis was that administering a fermented dairy product containing 16 x 109 colony-forming units (CFU) of LcS could result in the desired outcome.

The Study Method on Lactobacillus Casei Shirota on Renal Disease Patients

In this randomized, controlled clinical trial, patients were provided the LcS: 8 x 10 CFU for Group A and 16 x 10 CFU for Group B. Baseline fasting blood samples were obtained for urea and creatinine (CrS) levels before the patients were randomly assigned into groups. Each patient had also received a daily food consumption diary to record food and lactobacillus (dairy drink) consumption for the 15 days before the follow-up visit. All ate a diet of 30 kilocalories/kilogram (kg)/weight and 0.8 gram/kg/weight of protein. Patients were followed-up at the end of the second and eighth weeks to assess their compliance with the diet and LcS. At the end of the treatment period, fasting blood samples were again collected to determine the final concentrations of blood urea and CrS. 

The Results

Thirty patients with CKD completed this study. An almost 11% decrease was found in the blood urea concentrations for patients treated with the 16 x 109 dose, which was significant compared with the baseline measurement.

The Conclusion

In conjunction with a standard diet, a dose of 16 x 109 CFU of Lactobacillus Casei Shirota can significantly decrease urea concentrations by more than 10% in the blood of patients with stage 3 and stage 4 chronic renal failure.


Effect of Probiotics on Human Blood Urea Levels in Patients with Chronic Renal Failure

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