Clinical and experimental use of probiotic formulations for management of end-stage renal disease: an update.

Nowadays kidney transplantation and dialysis are the only available therapies for end-stage renal disease management. They imply a considerable increase in plasma concentration of uremic wastes including creatinine, urea and uric acid. These invasive procedures impose high social costs that prevent many low-income countries from adequately treating the patients affected by renal insufficiency. For years, many studies on uremic waste removal through the gut lumen have been published with conflicting results. More recently, microencapsulation of probiotic bacteria has been performed by different research groups. This evidence has opened a new perspective on therapeutic modification of gut bacterial flora in the context of renal disease. This review gives an overview of the experimental and clinical use of probiotic formulations in the context of end-stage renal disease.