Opinion Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Dec 25, 2024; 13(4): 98719
Published online Dec 25, 2024. doi: 10.5527/wjn.v13.i4.98719
Probiotic interventions in peritoneal dialysis: A review of underlying mechanisms and therapeutic potentials
Natalia Stepanova
Natalia Stepanova, Department of Nephrology and Dialysis, State Institution “O.O. Shalimov National Scientific Center of Surgery and Transplantology of the National Academy of Medical Science of Ukraine", Kyiv 03680, Ukraine
Natalia Stepanova, Department of Nephrology, Medical Center “Nephrocenter”, Kyiv 03057, Ukraine
Author contributions: Stepanova N is the sole contributor to the article; Stepanova N has read and approved the final manuscript.
Conflict-of-interest statement: Dr. Stepanova has nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Natalia Stepanova, DSc, PhD, Academic Research, Chief Doctor, Full Professor, Department of Nephrology and Dialysis, State Institution “O.O. Shalimov National Scientific Center of Surgery and Transplantology of the National Academy of Medical Science of Ukraine", Heroes of Sevastopol 30, Kyiv 03680, Ukraine. nmstep88@gmail.com
Received: July 3, 2024
Revised: September 18, 2024
Accepted: October 22, 2024
Published online: December 25, 2024
Processing time: 126 Days and 17.2 Hours
Abstract

Peritoneal dialysis (PD) is a commonly used modality for kidney replacement therapy for patients with end-stage kidney disease (ESKD). PD offers many benefits, including home-based care, greater flexibility, and preservation of residual kidney function compared to in-center hemodialysis. Nonetheless, patients undergoing PD often face significant challenges, including systemic inflammation, PD-related peritonitis, metabolic disorders, and cardiovascular issues that can negatively affect their quality of life and treatment outcomes. Recent studies have demonstrated the crucial role of the gut microbiome in overall health and treatment results, supporting the hypothesis that probiotics may bring potential benefits to the general population of ESKD patients. However, specific data on probiotic use in PD patients are limited. This opinion review aims to summarize the current knowledge on the relationship between PD and the gut microbiome and offers a novel perspective by specifically exploring how probiotic interventions could improve the outcomes of PD treatment. The review also outlines some clinical data supporting the effectiveness of probiotics in patients undergoing PD and considers the difficulties and restrictions in their application. Based on the current knowledge gaps, this study seeks to explore future research directions and their implications for clinical practice.

Keywords: Peritoneal dialysis; Probiotics; Gut; Microbiota; Inflammation; Effectiveness; Treatment

Core Tip: One essential strategy for optimizing peritoneal dialysis (PD) outcomes may involve exploring probiotic interventions to modulate the intestinal microbiome. Recent research highlights altered gut microbiota in PD patients and their impact on inflammation, residual kidney function, and risks of peritonitis, technique failure, and cardiovascular disease. Probiotics could enhance intestinal defenses, regulate immune responses, and manage inflammation, potentially benefiting PD patients. Despite the limited data on probiotics for this patient cohort, exploring their use may represent a new approach to improving patients’ clinical outcomes and the sustainability of dialysis, with further research required to uncover their full potential and limitations.