Chronic Kidney Disease
Conditions
Keywords
Probiotics, Kibow Biotics, Dialysis, Gut based uremic toxin removal
Brief summary
A specifically formulated probiotic product comprised of defined and tested microbial strains may afford renoprotection in what has been generally called Enteric DialysisTM. However, it is also referred to as enteric toxin reduction technology. Our hypothesis is to assess the potential benefits in devising a bowel-based probiotic formulation (Kibow® Biotics/RenadylTM) as a dietary supplement product for patients undergoing dialysis along with standardized care of treatment.
Detailed description
Probiotics are increasingly utilized clinically. As their safety and health benefits are established, it is reasonable to anticipate that probiotic bacteria will be incorporated into a growing number of clinical regimens, as a dietary supplement. Extensive in vitro R&D investigations in Kibow's laboratories Bacterial strains studied were a mixture of patented and proprietary strains of Streptococcus thermophilus (KB27), Lactobacillus acidophilus (KB31) and Bifidobacterium longum (KB35). Oral administration of these bacterial formulations, tested in the 5/6th nephrectomized rat model (at Thomas Jefferson University, Phila., PA) and minipig model (at Indiana University, Indianapolis, IN), decreased both blood urea nitrogen (BUN) and serum creatinine (Scr) levels. Two independent veterinarians investigated the effect of Kibow Biotics® in cats and dogs (of both genders and varying body weights) with moderate to severe kidney failure. Based on positive results, this formulation, marketed and distributed as AzodylTM, is currently licensed for veterinary applications to Vetoquinol USA. Pilot scale studies, double blind, placebo controlled, cross-over studies for six months conducted in 45 patients in USA, Canada, Argentina, and Nigeria demonstrates reduction of BUN (P\>95%) and improved quality of life (P\>95%). Decrease in creatinine and uric acid levels were also observed. However, these studies were based on correlating the age of geriatric cats and dogs with moderate to significant kidney failure to human geriatric conditions.
Interventions
6 month, double-blind, cross-over, wash-out, placebo controlled study in an outpatient setting. Each patient takes two capsules, three times a day (180 CFU/day).
Sponsors
Study design
Eligibility
Inclusion criteria
* Currently on hemodialysis * 18 to 75 years of age * Willing to give informed consent * Baseline serum creatinine \>2.5 mg/dL
Exclusion criteria
* Pregnant or nursing women * Refusal to sign the informed consent form * Documented to have HIV/AIDS/Liver disease * Active dependency on drugs or alcohol * Currently on anticoagulant therapy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 15-20% Changes in BUN. | 6 months |
| 15-20% Changes in Creatinine | 6 months |
| 15-20% Changes in CRP | 6 months |
| 15-20% Changes in Uric Acid Levels | 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To observe inflammatory and oxidative stress biomarkers. | 6 months | Observe inflammatory markers IL-1beta, NF-kappaB, Protein Bound Pentosidine, Beta2 Microglobulin, Indoxyl sulfate, Phenols, p-cresols, and guanadine metabolites from blood serum. |
| Observation and analysis of patient fecal matter. | 6 months | Observation and analysis of patient fecal matter to determine bacterial flora levels that are present in the stool. |
| Quality of life outcome based on SF 36 questionnaire. | 6 months | — |
Countries
United States