Effect of Synbiotic and Probiotic Supplementation on Serum Levels of Endothelial Cell Adhesion Molecules in Hemodialysis Patients: a Randomized Control Study

  • Neda Haghighat
  • Majid MohammadshahiEmail author
  • Shokouh Shayanpour
  • Mohammad Hossein Haghighizadeh


The aim of this study was to investigate the effect of synbiotic and probiotic supplementation on serum vascular dysfunction and necrosis markers in hemodialysis (HD) patients. In this randomized, double-blind, placebo-controlled trial, 75 HD patients were randomly assigned to either the synbiotic or probiotic or placebo group. The patients in the synbiotic group received 15 g of prebiotics and 5 g probiotic powder containing Lactobacillus acidophilus strain T16 (IBRC-M10785), Bifidobacterium bifidum strain BIA-6, Bifidobacterium lactis strain BIA-6, Bifidobacterium longum strain LAF-5 (2.7 × 107 CFU/g each) in sachets (n = 25), whereas the probiotic group received 5 g probiotics same to the first group with 15 g of maltodextrin powder in sachets (n = 25) and the placebo group received 20 g of maltodextrin powder in sachets (n = 25) for 12 weeks. At baseline and the end of the study, serum concentrations of soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), cytokeratin 18 (CK-18) as the necrosis marker, uric acid, and phosphate levels were measured. Feces also were collected for microbiota colony counting. Serum ICAM-1 level reduced significantly in the synbiotic group after the intervention period (P = 0.02), and this reduction was significantly different in the synbiotic group in comparison to the placebo group (P = 0.03). Serum levels of VCAM-1 and CK-18 were not significantly different between the groups. However, the reduction in serum levels of VCAM-1 in the synbiotic group was significantly higher in comparison to the placebo group (P = 0.01). Multivariate linear regression analysis revealed that ∆ phosphate was the sole independent determinant of ∆ICAM-1 (P = 0 < 001). The study indicated that synbiotic supplementation reduced serum ICAM-1 level, which is a risk factor for cardiovascular diseases in HD patients, but has no effect on the necrosis marker. Trial registration: (IRCT2017041233393N1).


Synbiotic Probiotic Hemodialysis Cardiovascular Cytokeratin 18 



We thank all the volunteers who participated in this study. We are grateful to Tak Gen Zist (Company, Tehran, Iran) for providing Bioflora® (a multispecies probiotic supplement) for the present study. The authors would like to thank the staff of the Emam Khomeini dialysis center (Ahvaz, Iran) for their assistance with this project.

Funding Information

This study was supported by grants from Vice Chancellor of Research, Ahvaz University of Medical Sciences (Ahvaz, Iran).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Neda Haghighat
    • 1
  • Majid Mohammadshahi
    • 1
    • 2
    Email author
  • Shokouh Shayanpour
    • 3
  • Mohammad Hossein Haghighizadeh
    • 4
  1. 1.Department of Nutrition, Nutrition and Metabolic Diseases Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
  2. 2.Department of Nutrition, Hyperlipidemia Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
  3. 3.Department of Nephrology, Golestan HospitalAhvaz Jundishapur University of Medical SciencesAhvazIran
  4. 4.Department of Biostatistics and Epidemiology, Faculty of Public HealthAhvaz Jundishapur University of Medical SciencesAhvazIran

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