Meta Analysis Of Efficacy And Safety Of Microecological Preparation In Patients With Chronic Kidney Disease Undergoing Dialysis

Objective:To investigate the efficacy and safety of microecological preparation in maintenance dialysis patients.Methods:Public published RCTs of comparing the effect of microecological preparation with placebo on CKD of January 1950 to December 2017 were collected from PubMed,Cochrane Library database,MEDLINE,EMBASE,CNKI,Wanfang Data and so on.Relevant publications were included and analyzed according to the inclusion criteria by two reviewers separately,including indoxyl sulfate,C-reactive protein,interleukin-6,tumor necrosis factor-?,serum creatinine,blood urine nitrogen and adverse reactions.The meta-analysis was measured with RevMan5.3 software.Mean difference(MD),standardized mean difference(SMD)and its 95%CI were used to evaluate continuous data,relative risk degree(RR)and its 95%CI were used to evaluate second classification data.The heterogeneity is expressed with I~2.When there was no evidence of significant heterogeneity(P<0.1,I~2>50%),effect sizes were decided using a fixed-effects model,and otherwise we utilized a random effects model.Results:We ultimately included 8 randomized controlled trials that conformed to the inclusion criteria,in which the treatment group and control group was 155 and 147cases,respectively.In comparison with the control group,microecological preparat-ions(probiotics and prebiotics)were proved to the benefit of decreasing IS[MD=-1.09,95%CI=(-2.12,-0.06)]by 2 articles;There was no significant difference in CRP[MD=-0.28,95%CI=(-0.96,0.41)],IL-6[MD=-0.66,95%CI=(-1.97,0.64)],TNF-?[MD=-0.38,95%CI=(-1.32,0.56)],Scr[MD=-0.45,95%CI=(-2.8,1.89)]and BUN[MD=1.0,95%CI=(-5.67,7.68)].There were no adverse reactions in the treatment group.Conclusion:Probiotics and prebiotics may delay the progression of CKD safely,but it appears that large amount of stricter,multi-center high-quality randomized double-blind controlled trials are necessary to provide the curative effect and safety of microecological preparations treatment on dialysis patients.