PROBIOTIC supplementation significantly improved eGFR in patients with moderate to severe chronic kidney disease (CKD), according to a double-blind, randomised, placebo-controlled trial. The study investigated whether daily Lactobacillus plantarum supplementation could influence disease progression in patients with CKD Stage 3 or Stage 4.
The trial included 72 patients who received either daily Lactobacillus plantarum supplementation or placebo for six months. The primary outcome was the change in eGFR, providing a measure of kidney function over the study period.
The probiotic group demonstrated a significant increase in eGFR, whereas the placebo group experienced a significant decline. Treatment assignment was identified as the sole independent predictor of eGFR change.
The reported benefit was observed in patients with both Stage 3 and Stage 4 CKD. Similar findings were also reported among patients with and without diabetes, suggesting that the observed association was not limited to either subgroup.
Disease progression was also reported less frequently among participants receiving probiotics. No patients in the probiotic group experienced CKD progression during the study, compared with 8.6% of patients in the placebo group.
The study also examined urinary indoxyl sulfate, a gut-derived metabolite investigated in relation to the gut-kidney axis. Urinary indoxyl sulfate levels did not differ significantly between the probiotic and placebo groups. In addition, changes in urinary indoxyl sulfate were not correlated with improvements in eGFR.
These findings suggested that the observed effect of Lactobacillus plantarum supplementation on kidney function was independent of reductions in urinary indoxyl sulfate. The results therefore supported further investigation of probiotic supplementation as a potential approach to modifying CKD progression.
For clinicians, the findings indicated a potential therapeutic role for probiotics in patients with moderate to severe CKD, while the six-month trial provided the basis for further evaluation of the intervention and its underlying mechanisms.
Saleh SE et al. Effects of probiotic supplementation on disease progression in patients with moderate to severe chronic kidney disease: a randomized controlled trial. Sci Rep. 2026;16:27799.
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