{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T19:03:11Z","timestamp":1789066991312,"version":"build-2803163510"},"reference-count":76,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"crossref","award":["PI20\/00781"],"award-info":[{"award-number":["PI20\/00781"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Chronic kidney disease (CKD) is associated with gut microbiota alterations that contribute to increased inflammation and the generation of uremic toxins and may worsen the disease progression. While probiotics may improve the pro-inflammatory cytokine profile, their effects on mineral metabolism, vascular calcification (VC), and CKD progression remain unclear. We aimed to evaluate the impact of a commercial probiotic (Probimel) supplementation on kidney function, mineral metabolism, inflammation and VC in both an experimental rat model and patients with advanced CKD and VC. The experimental model of VC was performed through 5\/6 nephrectomy (Nx), a high-phosphate diet, and calcitriol. Animals were divided into three groups: Sham, Nephrectomy, and Nephrectomy + Probiotic. In the exploratory clinical study, 23 patients with advanced stage 5 CKD and VC were randomized and either received or did not receive daily probiotics for 6 months. Kidney function, mineral metabolism, uremic toxins, inflammation, VC, and fecal microbiota were evaluated. Probiotic supplementation decreased interleukin-6 (IL-6) and interpheron-\u03b3 (IFN-\u03b3) and levels of the uremic toxin, indoxyl sulfate (IS), in the experimental model. However, no clear evidence of improvement in kidney function or vascular calcification was observed in either rats or patients with this probiotic. Under our experimental and clinical conditions, the selected probiotic did not modify key parameters related to CKD progression or VC.<\/jats:p>","DOI":"10.3390\/toxins18010006","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:27:47Z","timestamp":1766500067000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Probiotic Supplementation in Chronic Kidney Disease: Outcomes on Uremic Toxins, Inflammation, and Vascular Calcification from Experimental and Clinical Models"],"prefix":"10.3390","volume":"18","author":[{"given":"Teresa","family":"Obrero","sequence":"first","affiliation":[{"name":"Research Group: \u201cCalcium Metabolism. Vascular Calcification\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Victoria","family":"Pend\u00f3n-Ruiz de Mier","sequence":"additional","affiliation":[{"name":"Nephrology Service, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Research Group: \u201cNephrology. Cellular Damage in Chronic Inflammation\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose E.","family":"Gordillo-Arnaud","sequence":"additional","affiliation":[{"name":"Radiodiagnostics Service, Reina Sofia University Hospital, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Jim\u00e9nez Moral","sequence":"additional","affiliation":[{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Research Group: \u201cNephrology. Cellular Damage in Chronic Inflammation\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Vidal","sequence":"additional","affiliation":[{"name":"Research Group: \u201cNephrology. Cellular Damage in Chronic Inflammation\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1306-0574","authenticated-orcid":false,"given":"F\u00e1tima","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Research Group: \u201cNephrology. Cellular Damage in Chronic Inflammation\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Carmona","sequence":"additional","affiliation":[{"name":"Nephrology Service, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3696-582X","authenticated-orcid":false,"given":"Mar\u00eda Encarnaci\u00f3n","family":"Rodr\u00edguez-Ortiz","sequence":"additional","affiliation":[{"name":"Research Group: \u201cCalcium Metabolism. Vascular Calcification\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Research Group: \u201cNephrology. Cellular Damage in Chronic Inflammation\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Isabel","family":"Torralbo","sequence":"additional","affiliation":[{"name":"Research Group: \u201cCalcium Metabolism. Vascular Calcification\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"},{"name":"Research Group: \u201cNephrology. Cellular Damage in Chronic Inflammation\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0983-9459","authenticated-orcid":false,"given":"Raquel","family":"Ojeda","sequence":"additional","affiliation":[{"name":"Nephrology Service, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cayetana","family":"Moyano","sequence":"additional","affiliation":[{"name":"Nephrology Service, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Sanchez-Ramade","sequence":"additional","affiliation":[{"name":"Nephrology Service, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Mesa","sequence":"additional","affiliation":[{"name":"Radiodiagnostics Service, Reina Sofia University Hospital, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"L\u00f3pez-Ruiz","sequence":"additional","affiliation":[{"name":"Radiodiagnostics Service, Reina Sofia University Hospital, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Vald\u00e9s-D\u00edaz","sequence":"additional","affiliation":[{"name":"Research Group: \u201cCalcium Metabolism. 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Vascular Calcification\u201d, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8139-3840","authenticated-orcid":false,"given":"Cristian","family":"Rodelo-Haad","sequence":"additional","affiliation":[{"name":"Nephrology Service, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of C\u00f3rdoba (Spain), 14004 Cordoba, Spain"},{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud (RICORS), Carlos III Health Institute, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0273-3393","authenticated-orcid":false,"given":"Mar\u00eda","family":"\u00c1lvarez-Benito","sequence":"additional","affiliation":[{"name":"Radiodiagnostics Service, Reina Sofia University Hospital, 14004 Cordoba, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7641-4707","authenticated-orcid":false,"given":"Griet","family":"Glorieux","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Pediatrics, Nephrology Division, Ghent University Hospital, 9000 Ghent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9380-6614","authenticated-orcid":false,"given":"Mariano","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Research Group: \u201cCalcium Metabolism. 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