Designing healthy diets for people with chronic kidney disease (CKD) is tricky.
Protein, electrolytes, minerals and fluids must be tightly monitored for the intent of striking a balance between optimum intake for health and minimal stress to the damaged kidneys (reduced glomerular filtration rate). At the same time, energy requirements must be respected. It’s a tight-rope walk that may vary from day to day.
Because prebiotic foods support microbes in health and disease, clinicians who work with CKD patients ask how they fit in.
Lindsey Zirker of the Idaho Kidney Institute published Benefit and Use of Prebiotics in Patients With Chronic Kidney Disease in the Journal of Renal Nutrition.
Prebiotics can do the following for CKD-sufferers, wrote Zirker:
- Reduce constipation
- Improve diarrhea
- Assist in calcium absorption
- Improve immune function
In addition, there are a few studies which suggest that prebiotics may decrease inflammation and improve mortality rates in CKD.
In 2012, a team at VA Salt Lake City Health Care System in the USA looked at data from 14,543 participants in the National Health and Nutrition Examination Survey III.
CKD prevalence was nearly 6%.
When total fiber (not all prebiotic types though) increased by 10 grams per day, inflammation, as marked by serum C-reactive protein levels, declined. The authors led by VM Krishnamurthy wrote that: “Dietary total fiber intake was not significantly associated with mortality in those without but was inversely related to mortality in those with kidney disease. “
The Zirker article here includes excellent tables listing both food and supplement sources of common prebiotics. It is tricky because minerals and electrolyte content must be considered and many of the prebiotic fibers may be high in them, as well as fluid.
Zirker states: “To date, no recommendations for prebiotics have been made for CKD patients. However, health benefits are seen with intake of 3 g of short-chain fructooligosaccharides (FOS) and up to 8 g for mixed short- and long-chain inulin.”