Abstract

Introduction

During acute kidney injury (AKI) due to sepsis, the intestinal microbiota changes to dysbiosis, which affects the kidney function recovery (KFR) and amplifies the injury. Therefore, the administration of probiotics could improve dysbiosis and thereby increase the probability of KFR.

Methods

In this double-blind clinical trial, patients with AKI associated with sepsis were randomized (1:1) to receive probiotics or placebo for 7 consecutive days, with the objectives of evaluate the effect on KFR, mortality, kidney replacement therapy (KRT), urea, urine volume, serum electrolytes and adverse events at day 7.

Results

From February 2019 to March 2022, a total of 92 patients were randomized, 48 to the Probiotic and 44 to Placebo group. When comparing with placebo, those in the Probiotics did not observe a higher KFR (HR 0.93, 0.52–1.68, p = 0.81), nor was there a benefit in mortality at 6 months (95% CI 0.32–1.04, p = 0.06). With probiotics, urea values decreased significantly, an event not observed with placebo (from 154 to 80 mg/dl, p = 0.04 and from 130 to 109 mg/dl, p = 0.09, respectively). Urinary volume, need for KRT, electrolyte abnormalities, and adverse events were similar between groups. (ClinicalTrial.gov NCT03877081) (registered 03/15/2019).

Conclusion

In AKI related to sepsis, probiotics for 7 consecutive days did not increase the probability of KFR, nor did other variables related to clinical improvement, although they were safe.

Details

Title
Probiotics in septic acute kidney injury, a double blind, randomized control trial
Author
Chávez-Íñiguez, Jonathan S 1   VIAFID ORCID Logo  ; Miguel Ibarra‑Estrada 2 ; Alejandro Martínez Gallardo-González 1 ; Cisneros-Hernández, Ari 3 ; Rolando Claure-Del Granado 4 ; Chávez-Alonso, Gael 5 ; Hernández-Barajas, Eduardo M 5 ; Romero-Muñoz, Alexia C 1 ; Ramos-Avellaneda, Fidel 1 ; Prieto-Magallanes, Manuel L 1 ; Plascencia-Cruz, Marcela 1 ; Tanaka-Gutiérrez, Jarumi A 5 ; Pérez-Hernández, Cristina 5 ; Navarro-Blackaller, Guillermo 6 ; Medina-González, Ramón 6 ; Alcantar-Vallin, Luz 1 ; Renoirte-López, Karina 1 ; García-García, Guillermo 5 

 Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico 
 Intensive Care Unit, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico 
 Division of Nutrition, NIN Institute, Guadalajara, Jalisco, México 
 Division of Nephrology, Hospital Obrero #2 – C.N.S, Universidad Mayor de San Simon School of Medicine, Cochabamba, Bolivia 
 Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico 
 Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico 
Publication year
2023
Publication date
2023
Publisher
Taylor & Francis Ltd.
ISSN
0886022X
e-ISSN
15256049
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3003358450
Copyright
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.