An interesting poster study was presented during the recent Spring Clinical Meetings (SCM18), in Austin, Texas. The event, organized by the USA National Kidney Foundation, highlighted cutting-edge research, presenting the newest developments related to all aspects of nephrology practice. An important objective of SCM18 was to present the latest insights into Chronic Kidney Disease (CKD) care.
End Stage Renal Disease (ESRD) is the last stage of CKD. When ESRD develops, dialysis or Kidney transplant is necessary in order to stay alive.
Kidneys are vital to overall health. If their function is reduced by just 10% – 15% of normal, they cannot effectively remove waste or excess fluid from blood. As a result, fluids and waste accumulate in the body, the electrolyte levels become unbalanced, sodium causes water retention, excess potassium can cause irregular heart rhythm and even cardiac arrest, low magnesium levels lead to changes in your mental state while too much magnesium makes you weak. Calcium cannot be absorbed because the kidneys cannot keep up with production of the parathyroid hormone (PRH) which is responsible to interact with vitamin D and create Calcitriol, the actual substance that does the job of absorbing the calcium. Kidneys also control the erythropoietin hormone, responsible for the production of red blood cell, which affects the oxygenation of your body cells and this downturn goes on and on.
Kidneys also produce renin, an enzyme that regulates blood pressure, potassium and sodium levels. This enzyme is released when blood pressure drops to generate a chemical reaction, to produce angiotensin, which in turn acts on venous and arterial smooth muscles to cause vasoconstriction (constriction of the blood vessels) to increase blood pressure. The same time, angiotensin causes the release of aldosterone, another hormone, produced by the adrenal glands, that causes the kidneys to excrete potassium and to keep sodium (salt). Due to the accumulating salt, the body retains water which results in increased blood pressure and blood volume. People with ESRD, often have high blood pressure and great difficulty regulating it due to excess renin production by the kidneys.
The poster study during SCM18, revealed potential benefits of probiotics for ESDR patients in regards to inflammation, uremic toxins and gastrointestinal (GI) symptoms. Previous to that, there were earlier animal studies that demonstrated the beneficial effect of probiotics to reduce uremic toxins and increase the lifespan in uremic rats.
Dr. Spencer Hatch, an internist at University of Mississippi medical center and co-author of the study, did a meta-analysis on the effects of probiotics and all the inflammatory markers with ESRD. He looked at 178 ESRD patients and found a significant reduction in serum C-reactive protein (CRP) from baseline to post-probiotic course. Such CRP reduction was decreasing the total inflammation in the body, leading to better outcomes for ESRD patients. There was significant improvement in the overall GI symptoms and significant reduction in protein-bound uremic toxins. The standardized mean difference of these two measures were -1.04 and -0.61, respectively.
Such study demonstrates the ever-increasing interest by reputable authorities in the medical field to thoroughly and seriously investigate the role of probiotics for better health, longevity and even as a therapeutic strategy for disease. It definitely opens a wide spectrum of possibilities and opportunity. For additional perspectives from the probiotic research front, visit our Facebook page.