Probiotics for Kidney Health: Can Lactobacillus Rhamnosus Help?

study PMID: 40744977

Quick Summary: Research shows that a specific type of probiotic, Lactobacillus rhamnosus, may help people with chronic kidney disease. It seems to reduce harmful toxins in the body and lower inflammation.

What The Research Found

This study looked at how Lactobacillus rhamnosus (specifically, a strain called L34) affects people with chronic kidney disease (CKD). The researchers found that taking this probiotic for a short time:

Reduced certain toxins: It lowered levels of some harmful substances in the body that build up in CKD.

Lowered inflammation: It helped reduce inflammation, which is a major problem in CKD.

Improved gut health: It seemed to improve the balance of bacteria in the gut and helped the gut lining work better.

The study also compared L34 to another common probiotic, Lactobacillus rhamnosus GG (LGG), and found they both had similar benefits.

Study Details

Who was studied: People with chronic kidney disease (stages 3-5) who were not on dialysis.

How long: The study lasted for 4 weeks.

What they took: Participants took either the L34 probiotic, the LGG probiotic, or a placebo (a "dummy" pill).

What This Means For You

If you have chronic kidney disease, this research suggests that taking a Lactobacillus rhamnosus probiotic might be helpful. It could potentially:

Reduce harmful toxins: This could help your kidneys work better.

Lower inflammation: This could help you feel better overall.

Improve gut health: This could lead to better digestion and overall well-being.

Important: Talk to your doctor before starting any new supplements, including probiotics. They can help you decide if it's right for you and what dosage to take.

Study Limitations

Short study: The study only lasted 4 weeks, so we don't know if the benefits last long-term.

Specific population: The study was done on people in Thailand, so the results might be different for people in other places.

More research needed: We need more studies to confirm these findings and understand exactly how the probiotics work.

Dosage unknown: The exact dose of the probiotic used in the study wasn't specified.

Key Findings

This study demonstrated that Lacticaseibacillus rhamnosus L34 (L34), isolated from the Thai population, significantly reduced gut-derived uremic toxins (GDUTs) and systemic inflammation in patients with non-dialysis-dependent chronic kidney disease (CKD) stages 3–5. While total indoxyl sulfate (IS) levels remained unchanged, L34 improved gut permeability (reduced beta-D-glucan) and corrected gut dysbiosis (via fecal microbiome analysis). Both L34 and the reference strain L. rhamnosus GG (LGG) showed comparable anti-inflammatory effects in vitro and in patients, outperforming placebo. L34-conditioned media also protected intestinal and immune cells (Caco-2 enterocytes, THP-1 macrophages, neutrophils) against IS-induced damage.

Study Design

The study combined a 4-week before-and-after trial with L34 and a randomized placebo-controlled trial (RCT) comparing placebo, L34, and LGG in CKD patients. In vitro experiments tested probiotic-conditioned media on cells exposed to IS. The sample included patients from Thailand with CKD stages 3–5, though exact sample size, age, and gender demographics were not specified in the provided summary. Duration of follow-up was limited to 4 weeks, focusing on short-term effects.

Dosage & Administration

The summary did not specify the dosage, formulation, or administration route (e.g., capsules vs. powder) of L34 or LGG. However, the intervention duration was 4 weeks for both strains, with comparisons to placebo.

Results & Efficacy

Uremic toxins: GDUTs decreased significantly with L34 (except total IS), though quantitative reductions (e.g., percentage changes) were not reported.
Systemic inflammation: Markers such as cytokines and neutrophil extracellular traps (NETs; measured via citrullinated histone 3, cell-free DNA, and nuclear morphology) were attenuated post-L34 administration.
Gut permeability: Beta-D-glucan levels dropped, indicating improved barrier function (no effect on endotoxemia).
Gut microbiome: L34 corrected dysbiosis, though specific microbial shifts (e.g., genus-level changes) were not detailed.
In vitro: L34-conditioned media reduced IS-induced inflammation and cellular injury.
Comparative efficacy: Both L34 and LGG showed similar anti-inflammatory effects in patients and in vitro, with statistically significant improvements over placebo.

Limitations

Unspecified sample size: The lack of participant numbers limits interpretation of statistical power.
Short duration: Effects were measured over 4 weeks, leaving long-term efficacy and safety unknown.
Limited demographics: The study focused on Thai CKD patients, potentially restricting generalizability.
Missing dosage details: Without dose information, reproducibility and optimal dosing remain unclear.
Incomplete mechanistic insights: While anti-inflammatory effects were observed, the specific active compounds (e.g., metabolites) responsible were not identified.
Publication status: The study’s future publication date (2025) suggests preliminary or unverified data.

Clinical Relevance

For CKD patients, this study suggests that L. rhamnosus strains (L34 and LGG) may serve as adjunct therapies to reduce systemic inflammation and GDUTs, potentially slowing disease progression. The findings support the use of probiotics targeting gut health in CKD management, though strain-specific effects and mechanisms require further exploration. Supplement users should note that both strains were effective, but optimal dosing and long-term benefits remain uncertain. Additionally, the role of anti-inflammatory metabolites from L34 (distinct from LGG) highlights the importance of strain selection in probiotic formulations.

Note: This analysis is based on the provided summary. Full details (e.g., p-values, confidence intervals, microbial composition shifts) may be available in the original study (PMID: 40744977).