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Investigating the effect of synbiotics on uremic toxin concentrations in the pre-dialysis population.

Phase 2
Recruiting
Conditions
Chronic Kidney Disease
Renal and Urogenital - Kidney disease
Diet and Nutrition - Other diet and nutrition disorders
Registration Number
ACTRN12613000493741
Lead Sponsor
Princess Alexandra Hospital
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
All
Target Recruitment
40
Inclusion Criteria

*CKD stage IV: GFR stable between 10-30 ml/min/1.73m2 (for the past 3 months)
*Able to provide informed consent

Exclusion Criteria

*Previous transplant or on immunosuppressants
*Receiving/ or have received radiation to the bowel
*Received prebiotic, probiotic or anti-biotic therapy within 1 month of study commencement
*Non-English speaking
*Unable/unwilling to comply with frequent follow-up
*Active medically diagnosed Irritable Bowel Syndrome
*Life expectancy limited due to pre-existing malignancy or other disease (<6 months)
*Likely to progress to dialysis within 6 months as determined by the treating physician
*Likely transplant recipient within 6 months
*Pregnancy
*Severely malnourished (Subjective Global Assessment: C)

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Free and protein-bound concentrations of serum- indoxyl sulphate and p-cresyl sulphate[Baseline, mid point (3 weeks) and end of intervention (6 weeks) for each arm]
Secondary Outcome Measures
NameTimeMethod
Inflammation (serum- CRP, IFN-gamma, TNF-alpha, IL-6) and Oxidative stress (plasma- GPX, MDA and 8-Isoprostanes)[Baseline, mid point (3 weeks) and end of intervention (6 weeks) for each arm];Renal tubule damage & CKD progression<br>Urinary Kidney Injury Molecule1 (KIM1) and slope of reciprocal serum concentration of creatinine and creatinine clearance (24hr urine collection) vs. time plot, proteinuria and eGFR-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula.[Baseline, mid point (3 weeks) and end of intervention (6 weeks) for each arm];Gut microbiota (fecal sample- next generation sequencing)[Baseline and end of intervention (6 weeks) for each arm];Endotoxemia- (plasma lipopolysaccharides)[Baseline, mid point (3 weeks) and end of intervention (6 weeks) for each arm];Quality of Life (KDQOL)[End of intervention (6 weeks) (for each arm)];Dietary compliance- diet history interviews and 24hr recalls[Baseline, mid point (3 weeks) and end of intervention (6 weeks) for each arm]
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