Prebiotic Supplementation in Kidney Transplant Recipients for Preventing Infections and Gastrointestinal Upset: A Randomized Controlled Feasibility Study

Samuel Chan, Carmel M Hawley, Elaine M Pascoe, Christopher Cao, Scott B Campbell, Katrina L Campbell, Ross S Francis, Rachael Hale, Nicole M Isbel, Mark Morrison, David W Johnson

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

BACKGROUND: Modulating the large intestinal microbiome of kidney transplant recipients (KTR) may reduce infectious complications. The aim of this study was to assess the feasibility of a randomized controlled trial of prebiotics in reducing infections and gastrointestinal symptoms in KTR.

METHODS: Acute KTR were recruited to a double-blind, placebo-controlled, randomized trial at a single kidney transplant center. Patients were provided with prebiotics or placebo for 7 weeks. The primary outcome was feasibility, defined as recruitment of ≥80% of eligible people within 6 months. Secondary outcomes included adherence and tolerability, participant retention in trial, proportions of participants providing serum and stool specimens, self-reported quality of life (QOL), gastrointestinal symptoms and infection events.

RESULTS: During the 7-week period, 72 patients met eligibility criteria, of whom 60 (83%) consented to participate (mean±SD age 53±12 years; 62% males). Fifty six (78%) participants were randomized (27 intervention and 29 control). While participants receiving intervention experienced reduced gastrointestinal symptoms (-0.28 [IQR -0.67 to 0.08] vs -0.07 [IQR -0.27 to 0], p=0.03), both control and intervention groups were similar in adherence (67% vs. 72%, p=0.36), tolerability (56% vs. 62%, p=0.64), QOL (-0.2 [IQR -0.6 to 0] vs. -0.2 [IQR -0.8 to 0], p=0.82) and infection events (33% vs. 34%, p=0.83). Blood and stool samples were collected from ≥90% of participants in both groups.

CONCLUSIONS: It is feasible to recruit and retain acute KTR in a randomized placebo-controlled trial examining the effect of prebiotics on infections and gastrointestinal symptoms. This study also showed that prebiotics significantly reduced gastrointestinal symptoms.

Original languageEnglish
Pages (from-to)718-725
Number of pages8
JournalJournal of Renal Nutrition
Volume32
Issue number6
Early online date3 Mar 2022
DOIs
Publication statusPublished - Nov 2022
Externally publishedYes

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