In an RCT assessing in CKD patients, the effect of an enteric-coated probiotic combination of Lactobacillus acidophilus , Bifidobacterium longum and Streptococcus thermophilus on the evolution of BUN, serum creatinine and uric acid, only a borderline significant decrease in BUN could be observed, which remained absent in close to 40% of subjects [ 85 ].
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The sentences
Together with observational studies showing a highly significant association between concentration of protein-bound toxins with hard endpoints such as cardio-vascular events, progression of renal failure and mortality [ 49 – 54 ], these data offer strong arguments in favour of a key role of indoxyl sulphate and p-cresyl sulphate in the uraemic syndrome.