Effects of dietary fibers on chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials
摘要
Chronic kidney disease (CKD) is a progressive disorder characterized by a reduced glomerular filtration rate, which eventually diminishes kidney functions and also damages the renal structure. CKD involves multiple pathogenesis pathways which may include oxidative stress, inflammation, and dysbiosis of gut microbiota. Dietary fibers for decades have been used for reducing or managing this type of pathogenesis. Therefore, we conducted a systematic review and meta‐analysis to summarize the available evidence and to explore the study characteristics as sources of heterogeneity. This involves studying the impact of dietary fibers on serum urea and serum creatinine levels of patients with CKD.
MethodsA search was conducted in PubMed, Google Scholar, and ScienceDirect for any studies published up to October 2024, as well as the references to any related studies that were found. We opt for studies that included data on middle-aged adults 22–72 years suffering from chronic kidney disease. The studies also needed to provide information on post-intervention outcomes on serum urea and creatinine levels. Quality assessment was performed using the Cochrane risk of bias assessment tools for randomized controlled/clinical trials. Random effects meta-analysis was used to calculate pooled mean differences (MDs) with 95% confidence intervals (CI); the analysis was conducted in RevMan 5.4.
ResultsTen studies met inclusion criteria, and the population of eight studies was suitable for conducting a meta-analysis. The outcome of urea analysis reveals the overall mean difference was −0.72 (95% CI: −1.84 to 0.41; p = 0.23) with low heterogeneity (I2 = 27%), indicating a significant reduction in the measured outcome favoring dietary fiber, with a highly significant p-value (P < 0.0001). As for creatinine, the pooled analysis yielded a mean difference of −1.9 (95% CI: −2.84 to −0.97; p = 0.84) with low heterogeneity (I2 = 0%), suggesting a slight reduction in the measured outcome with dietary fiber intervention.
ConclusionThe serum urea level is significantly reduced through dietary fiber intake. However, no such effects were observed on serum creatinine level. It could be due to heterogeneity in dosage type and fiber type. This is suggestive of further research and reviews on a large scale that can be performed to evaluate the effects.
Systematic review registration
A priori protocol was registered on PROSPERO (registration number: CRD42024605981).