Association between fibre intake and indoxyl sulphate/P-cresyl sulphate in patients with chronic kidney disease: Meta-analysis and systematic review of experimental studies

Background and objective: Indoxyl sulphate (IS) and p cresyl sulphate (PCS), which are difficult to excrete adequately out of the body, are closely related to the progression of chronic kidney disease (CKD) and various deuteropathy. Better than peritoneal dialysis (PD) and haemodialysis (HD), dietary fibre has been considered to reduce IS and PCS levels. In view of the absence of formal recommendations on fibre intake in CKD nutritional guidelines, we conducted this meta-analysis to assess the effects of dietary fibre on IS and PCS for CKD patients. Methods: The effects were pooled and expressed in terms of weighted mean difference (WMD) with 95% confidence interval (95% CI). Q test and I-2 statistics were used to assess the heterogeneity. Results: A total of 12 relevant estimates from 7 reports, including 203 CKD patients, showed that dietary fibre significantly reduced their PCS level (WMD = - 16.160, 95% CI: - 23.824, - 8.495). Conclusions: The meta-analysis produced a strong corroboration that dietary fibre intake does have a good therapeutic effect on patients with CKD. The conclusions need to be validated by randomised controlled experiments (RCT) with better design, larger samples, longer course of treatment and higher quality. (C) 2018 Published by Elsevier Ltd.