Detailed Description :

Chronic kidney disease (CKD) is a global health issue that has a substantial impact on affected

Individuals. The prognosis of dialysis patients is poor with 30 to 50 percent 5 year survival in

nondiabetic patients and 25 percent in diabetic patients. Cardiovascular diseaseaccounts for

approximately half of death of dialysis partients. Chonic inflammation, which is widely seen in long-

term dialysis patients, is associated with malnutrition, atherosclerosis and an increased mortality risk.

Inflammatory markers such as C-reactive protein (CRP), IL-6, Il-18 and TNF-alpha, are elevated in

dialysis and can predict cardiovascular envent and all-cause mortality.

Synbiotics ( combination of Probiotics and Prebiotics) are microorganisms given along with

Oligosaccharides that have beneficial properties for the host.  Three described benefits includes

suppression of growth or epithelial binding/invasion by pathogenic bacteria, improvement of

intestinal barrier function and modulation the immune systems.

Several probiotics preparations induce protective cytokines, including IL-10, and suppresses

proinflammmatory cytokines, such as TNF-alpha and IL-6. Intestinal microflora is deranged in

hemodialysis (HD) patients and Predialysis Patients as an increase in aerobic bacteria such as E.coli

and a decrease in anaerobic bacteria such as Bifidobacterium.   One study reported that oral

administration  of Bifidobacterium longumm in gastroresistant capsules decreases the the pre-HD

serum levels of homocysteine and indoxylsulfhate. Another small-scale study from Japan showed that

synbiotics containing lactobacilli and can reduce serum level of p-Cresol in HD patients. High –serum

p-cresyl sulfate and indoxyl sulfate levels were associated with overall mortality and cardiovascular

disease in HD patients.