Can Probiotics Supplementation Improve Glycemic and Renal Status in Diabetic Nephropathy? A Systematic Review and Meta-Analysis of Clini-cal Trials

Background & Aim: This meta-analysis was performed to quantify the effects of probi-otics on renal and glycemic biomarkers among patients with Diabetic Nephropathy (DN). Methods: Electronic databases were searched on May 10, 2020. All trials that investigated the ef-fect of probiotics on serum glycemic markers (Fasting Plasma Glucose [FPG], Hemoglobin A1C, Insulin, Homeostatic Model Assessment-Insulin Resistance [HOMA-IR], and Quantitative Insulin Sensitivity Check Index [QUICKI]), and renal status markers (Creatinine [Cr], Blood Urea Nitro-gen [BUN], and Glomerular Filtration Rate [GFR]) were included. Results: Seven trials that included 340 patients were identified for analysis. The results indicated that probiotics significantly reduced FPG (WMD=-19.08 mg/dl; 95% CI=-32.16,-5.99; P=0.004), HOMA-IR (WMD=-1.88; 95% CI=-3.63,-0.12; P=0.036), and Cr (WMD=-0.18 mg/dl; 95% CI=-0.26,-0.09; P<0.001) levels in DN patients; however, there was no statistically significant change in Hemoglobin A1C, Insulin, QUICKI, BUN, and GFR. Conclusion: This meta-analysis supports the potential use of probiotics in the improvement of some glycemic and renal biomarkers in patients with DN.