Effects Of Probiotics On Nutritional Status And Inflammation In End-stage Renal Disease Patients With Dialysis

ObjectiveTo observe the effects of probiotics on nutritional status and inflammation in end-stage renal disease（ESRD）patients with dialysis.Methods119 ESRD patients who received dialysis treatment（including hemodialysis and peritoneal dialysis）in our hospital from April 1^st,2019 to October 1^st,2019 were enrolled.The patients were randomly assigned,in a 2:1 ratio,to experimental group（oral probiotics）or control group（oral placebo）with single blind method.We assessed the effect of probiotics on nutrition,inflammation and immune status in ESRD patients with dialysis.The baseline characteristics of each group,including age,gender,hypertension,diabetes,serum C-reactive protein（CRP）,white blood cell（WBC）,percentage of medium and fine-grained cells（NE%）,hemoglobin（HB）,albumin（ALB）,blood calcium（Ca）,blood phosphorus（P）,triglyceride（TG）,total cholesterol（TC）,β-2 microglobulin,procalcitonin（PCT）,ferritin（Fer）,parathyroid hormone（PTH）were collected and tested.To compare the differences of above indicators before and after different stages of treatment,the propensity score matching（PSM）was used to control the skewness of baseline characteristics between the two groups,and balance the above indicators.Results1.Among 119 ESRD patients with dialysis,including 55 cases of hemodialysis（46.2%,11 cases in the control group and 44 cases in the experimental group）,and 64cases of peritoneal dialysis（53.8%,14 cases in the control group and 50 cases in the experimental group）,82 cases were male（68.9%）,and 37 cases were female（31.1%）.74 cases had high blood pressure（62.2%）,and 18 cases had diabetes（15.1%）.After PSM matching,in total 36 cases were matched with 18 pairs of patients（6 pairs of hemodialysis patients,12 pairs of peritoneal dialysis patients）.2.Patients in the experimental group had higher hemoglobin level,higher albumin level,and lower parathyroid than patients in the control group on 30^thday after taking the drug.The cases in the experimental group had higher hemoglobin level,higher albumin level,and lower parathyroid hormone level,adenosine,C-reactive protein andβ-2 microglobulin than those in the control group on 60^thday after taking the drugs（all P<0.05）.3.ESRD patients with peritoneal dialysis:on 30^thday after taking the drug,cases in the experimental group had higher hemoglobin level,lower T lymphocyte level,lower procalcitonin and lowerβ-2 microglobulin than cases in the control group;on60^thday after taking the drug,cases in the experimental group had higher hemoglobin level,higher albumin level,lower T lymphocyte level lower lymphocyte,procalcitonin andβ-2 microglobulin than those in the control group（all P<0.05）.On the 30^thday after discontinuation of probiotics,the levels of hemoglobin and albumin in the experimental group were still higher than those in the control group,but no significant differences（P>0.05）.ConclusionFor ESRD patients with dialysis,probiotics can improve the status of hemoglobin and albumin.It suggests that for ESRD patients with peritoneal dialysis,probiotics improve the nutritional status and reduce the inflammation.