Effect of probiotic and synbiotic administration on the nutritional status of hemodialysis patients: a randomized-controlled trial.
Walaa M Saad, Yara Moheb, Ehab Wafa et al.
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In 30 seconds
This single-blind randomized controlled trial assessed probiotic and synbiotic supplementation in 60 maintenance hemodialysis patients over 24 weeks. Participants received Lactobacillus plantarum, the same probiotic with oat fiber β-glucans, or standard care. Triceps skinfold thickness increased by 3.3 ± 2.2 mm with probiotic and 4.7 ± 2.2 mm with synbiotic, compared with 0.0 ± 1.6 mm with standard care (p < 0.001). BMI also increased more in both supplementation groups. Albumin rose within the probiotic group, but between-group differences were not significant; other reported biochemical outcomes did not change significantly.
Key findings
- Triceps skinfold thickness increased by 3.3 ± 2.2 mm with probiotic and 4.7 ± 2.2 mm with synbiotic, versus 0.0 ± 1.6 mm with standard care (p < 0.001).
- BMI increased by 1.4 ± 1.0 kg/m² with probiotic and 1.7 ± 0.4 kg/m² with synbiotic, versus 0.7 ± 0.9 kg/m² with standard care (p < 0.001).
- Albumin increased within the probiotic group by 0.25 ± 0.37 g/dL (p = 0.008), but between-group differences were not significant.
- No significant changes occurred in nPCR, total protein, cholesterol, or leptin; no serious adverse events were reported.
Why it matters
Nutritional impairment is common in hemodialysis, and this trial found improvements in two anthropometric markers with probiotic or synbiotic supplementation. The absence of significant between-group differences in albumin and changes in other biochemical measures means the findings support a limited nutritional signal rather than evidence of broad improvement across nutritional outcomes.
What to keep in mind
The trial was single-blind and included 60 patients followed for 24 weeks; reported benefits were mainly in anthropometric markers, with no significant between-group albumin difference.