Probiotic and Prebiotic Supplementation in Peritoneal Dialysis Patients
Impact of Synbiotic Supplementation in Peritoneal Dialysis Patients
The goal of this clinical trial is to learn if synbiotics work to lower inflammation in adults with chronic kidney disease who are on peritoneal dialysis. Synbiotics are daily capsules that contain a mix of probiotics (good bacteria) and prebiotics (fiber that feeds good bacteria).
The main questions it aims to answer are:
Do synbiotics lower the level of inflammation markers in the blood? Do synbiotics improve the nutritional status of the participants? Do synbiotics lower the number of peritonitis (peritoneal infections) episodes?
Researchers will compare synbiotics to a placebo to see if the treatment works. A placebo is a look-alike capsule that contains no active ingredients. Participants will:
Take 1 capsule every day for 6 months Visit the clinic at the start, at 3 months, and at 6 months for blood tests and nutrition checkups
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Descrição detalhada
This is a randomized, controlled, double-blind clinical trial designed to evaluate the clinical and biochemical impact of synbiotic supplementation in patients with chronic kidney disease undergoing peritoneal dialysis at the Regional Center for Kidney Diseases. Eligible participants will be randomly assigned in a 1:1 ratio into one of two parallel groups for a 6-month period:
- Synbiotic Group: Participants will receive one oral capsule daily in the morning before meals, containing prebiotic fibers (chicory inulin root and tapioca starch) and probiotic strains (Bifidobacterium longum, Lactobacillus acidophilus, and Streptococcus thermophilus) at a concentration of 7.5 x 10^12 CFU/100g.
- Placebo Group: Participants will receive one identical, inactive oral capsule daily.
Clinical and biochemical evaluations will be conducted at three distinct time points: Baseline (Visit 1), 3 months (Visit 2), and 6 months (Visit 3). At each visit, blood samples will be drawn to measure primary pro-inflammatory and uremic toxin markers, specifically p-cresol and indoxyl sulfate, alongside high-sensitivity C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Additionally, nutritional status will be evaluated using the Malnutrition-Inflammation Score (MIS). Secondary clinical outcomes, including the incidence of peritonitis episodes, will be documented throughout the entire 6-month study duration. To ensure protocol compliance, participant adherence will be tracked using two methods: Pill-counts conducted during each scheduled follow-up visit and periodic telephone calls between visits to provide reminders and monitor supplement intake.
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Estágio
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Elisa María Guadalupe Guerrero González, MD
- Número de telefone: 528182803788
- E-mail: eguerrerog@uanl.edu.mx
Estude backup de contato
- Nome: Giovanna Yazmín Arteaga Müller, MD, PhD
- Número de telefone: 528112512168
- E-mail: giomuller@gmail.com
Locais de estudo
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Nuevo León
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Monterrey, Nuevo León, México, 64460
- Recrutamento
- Hospital Universitario Dr. José E. González, Centro Regional de Enfermedades Renales (CRER)
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Contato:
- Irma Isabel Flores Ponzio, MD
- Número de telefone: 528127312940
- E-mail: Irmaflorespz24@gmail.com
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Contato:
- Heidi Daniela Hernández Francisco, MD
- Número de telefone: 528180259573
- E-mail: heididhf@gmail.com
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Investigador principal:
- Elisa María Guadalupe Guerrero González, MD
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Patients aged 18 years or older.
- Patients diagnosed with kidney disease who have been receiving peritoneal dialysis at home for at least 1 month.
Exclusion Criteria:
- Patients who are unable to eat or receive food through a feeding tube.
- Patients who have taken prebiotics or probiotics (supplements that support gut health) in the month before the study starts.
- Patients who used antibiotics in the month before the study starts.
- Patients who cannot attend the scheduled follow-up visits (missing the second follow-up appointment will result in being removed from the study).
- Note on non-adherence and withdrawal: Patients who are unable to take their assigned capsules regularly (taking less than 80% of the total capsules will result in being removed from the study).
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Cuidados de suporte
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Triplo
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
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Comparador de Placebo: Placebo
Participants assigned to this arm will receive one identical, inactive oral capsule daily for a period of 6 months.
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Oral administration of one identical, inactive oral capsule daily taken in the morning before meals for a period of 6 months.
The placebo capsule looks, tastes, and smells exactly like the intervention supplement but contains no active ingredients.
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Experimental: Synbiotic
Participants assigned to this arm will receive one oral capsule daily for a period of 6 months.
Each capsule contains a combination of probiotic strains and prebiotic fibers.
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Oral administration of an active nutritional supplement consisting of one capsule daily taken in the morning before meals for 6 months.
Each capsule contains a specific synbiotic formulation composed of probiotic strains (Bifidobacterium longum, Lactobacillus acidophilus, and Streptococcus thermophilus at 7.5 x 10^12 CFU/100g) combined with prebiotic soluble fibers (chicory inulin root and tapioca starch) designed to modulate the gut microbiota.
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O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline in serum high-sensitivity C-reactive protein (hs-CRP) at 3 and 6 months.
Prazo: Baseline (Month 0), Month 3, and Month 6.
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Serum hs-CRP levels will be measured to evaluate systemic inflammation.
The change will be assessed by comparing values at 3 and 6 months against the baseline values.
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Baseline (Month 0), Month 3, and Month 6.
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Change from baseline in Erythrocyte Sedimentation Rate (ESR) at 3 and 6 months.
Prazo: Baseline (Month 0), Month 3, and Month 6.
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Erythrocyte Sedimentation Rate (ESR) will be measured to evaluate systemic inflammation.
The change will be assessed by comparing values at 3 and 6 months against the baseline values.
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Baseline (Month 0), Month 3, and Month 6.
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Change from baseline in serum p-Cresyl Sulfate (pCS) levels at 3 and 6 months.
Prazo: Baseline (Month 0), Month 3, and Month 6.
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Serum levels of the microbiota-derived uremic toxin p-Cresyl Sulfate will be quantified to evaluate the effect of the synbiotic intervention over time.
The change will be assessed by comparing values at 3 and 6 months against the baseline values.
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Baseline (Month 0), Month 3, and Month 6.
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Change from baseline in serum Indoxyl Sulfate (IS) levels at 3 and 6 months.
Prazo: Baseline (Month 0), Month 3, and Month 6.
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Serum levels of Indoxyl Sulfate will be quantified as a key protein-bound uremic toxin to determine if the synbiotic intervention decreases its accumulation.
The change will be assessed by comparing values at 3 and 6 months against the baseline values.
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Baseline (Month 0), Month 3, and Month 6.
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Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change from baseline in Malnutrition-Inflammation Score (MIS) at 3 and 6 months.
Prazo: Baseline (Month 0), Month 3, and Month 6.
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The Malnutrition-Inflammation Score (MIS) will be used to assess the nutritional and inflammatory status of the patients.
The score ranges from 0 (normal) to 30 (severe malnutrition and inflammation), where a higher score indicates a more severe degree of malnutrition.
The change will be assessed by comparing values at 3 and 6 months against the baseline values.
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Baseline (Month 0), Month 3, and Month 6.
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Number of peritonitis episodes during the 6-month follow-up period.
Prazo: Up to 6 months.
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The total number of confirmed peritonitis episodes per patient will be recorded throughout the study to evaluate if the synbiotic intervention reduces the incidence of infectious complications compared to the placebo group.
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Up to 6 months.
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Elisa María Guadalupe Guerrero González, MD, Hospital Universitario. Dr. José Eleuterio González
Publicações e links úteis
Publicações Gerais
- Tian N, Li L, Ng JK, Li PK. The Potential Benefits and Controversies of Probiotics Use in Patients at Different Stages of Chronic Kidney Disease. Nutrients. 2022 Sep 29;14(19):4044. doi: 10.3390/nu14194044.
- Abenavoli L, Scarpellini E, Colica C, Boccuto L, Salehi B, Sharifi-Rad J, Aiello V, Romano B, De Lorenzo A, Izzo AA, Capasso R. Gut Microbiota and Obesity: A Role for Probiotics. Nutrients. 2019 Nov 7;11(11):2690. doi: 10.3390/nu11112690.
- Lim YJ, Sidor NA, Tonial NC, Che A, Urquhart BL. Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets. Toxins (Basel). 2021 Feb 13;13(2):142. doi: 10.3390/toxins13020142.
- Liu S, Liu H, Chen L, Liang SS, Shi K, Meng W, Xue J, He Q, Jiang H. Effect of probiotics on the intestinal microbiota of hemodialysis patients: a randomized trial. Eur J Nutr. 2020 Dec;59(8):3755-3766. doi: 10.1007/s00394-020-02207-2. Epub 2020 Feb 28.
- Brown EA, Davies SJ, Rutherford P, Meeus F, Borras M, Riegel W, Divino Filho JC, Vonesh E, van Bree M; EAPOS Group. Survival of functionally anuric patients on automated peritoneal dialysis: the European APD Outcome Study. J Am Soc Nephrol. 2003 Nov;14(11):2948-57. doi: 10.1097/01.asn.0000092146.67909.e2.
- Sabatino A, Regolisti G, Cosola C, Gesualdo L, Fiaccadori E. Intestinal Microbiota in Type 2 Diabetes and Chronic Kidney Disease. Curr Diab Rep. 2017 Mar;17(3):16. doi: 10.1007/s11892-017-0841-z.
- Arteaga-Muller GY, Flores-Trevino S, Bocanegra-Ibarias P, Robles-Espino D, Garza-Gonzalez E, Fabela-Valdez GC, Camacho-Ortiz A. Changes in the Progression of Chronic Kidney Disease in Patients Undergoing Fecal Microbiota Transplantation. Nutrients. 2024 Apr 10;16(8):1109. doi: 10.3390/nu16081109.
- Andreoli MCC, Totoli C. Peritoneal Dialysis. Rev Assoc Med Bras (1992). 2020 Jan 13;66Suppl 1(Suppl 1):s37-s44. doi: 10.1590/1806-9282.66.S1.37.
- Wieers G, Belkhir L, Enaud R, Leclercq S, Philippart de Foy JM, Dequenne I, de Timary P, Cani PD. How Probiotics Affect the Microbiota. Front Cell Infect Microbiol. 2020 Jan 15;9:454. doi: 10.3389/fcimb.2019.00454. eCollection 2019.
- Rysz J, Franczyk B, Lawinski J, Olszewski R, Cialkowska-Rysz A, Gluba-Brzozka A. The Impact of CKD on Uremic Toxins and Gut Microbiota. Toxins (Basel). 2021 Mar 31;13(4):252. doi: 10.3390/toxins13040252.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças urogenitais
- Processos Patológicos
- Doenças Urogenitais Masculinas
- Doenças renais
- Doenças Urológicas
- Doenças Urogenitais Femininas
- Doenças urogenitais femininas e complicações na gravidez
- Doença crônica
- Atributos da doença
- Insuficiência renal
- Condições Patológicas, Sinais e Sintomas
- Inflamação
- Insuficiência Renal Crônica
- Suplementos alimentares
- Comida
- Dieta, comida e nutrição
- Fenômenos fisiológicos
- Comida e bebidas
- Prebióticos
- Probióticos
- Sinbióticos
Outros números de identificação do estudo
Outros números de identificação do estudo
- NF25-00008
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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