Speaking at the Probiota Asia 2019 event in Singapore, Kibow Biotech Managing Director Dr Natarajan Ranganathan told the audience that probiotics can play an especially important role for Stage 3 and Stage 4 kidney disease patients.
“Even though kidney disease tends to not receive as much attention as others like diabetes or heart disease, it actually ranks ninth amongst the top ten leading causes of death in the United States,” he said.
“In addition, it is also the most expensive to treat globally – Stage 5 renal patients require either dialysis or kidney transplants, and these could be three times a week for four hours each session, meaning that lots and lots of time would also need to be spend on this.
“We identified a significant market need in Stage 3 and Stage 4 kidney disease or renal patients, some eight million individuals in the United States alone as compared to 0.6 million Stage 5 patients.”
For this segment, the target application using probiotics would be to help delay the need for dialysis, thus reducing the cost of care which is heaviest at Stage 5 – around US$40bn in total, whereas Stage 1 through to Stage 4 in total is less than double that number, at US$74bn.
“Healthy populations would see about 85% of good bacteria such as bifidobacteria and lactobacillus in their intestinal flora, but in chronic kidney disease, uremic toxins accumulate and promote the growth of pathogenic bacteria like staphylococci, leading to an imbalance in this flora and causing dysbiosis,” said Dr Ranganathan.
“The aim of introducing prebiotics and probiotics to these patients is to increase the number of good bacteria and thus alleviate the dysbiosis process.”
Zooming in on the kidney
The kidney has three major functions (regulatory enzyme/protein secretion, toxin excretion and overall system homeostasis) which need to be maintained in a ‘dynamic equilibrium’, but it is highly likely to go out of sync if chronic kidney disease occurs.
The excretory pathway was highlighted as a major area of focus, as Dr Ranganathan explained that this functions on a 24/7 basis and they believe reducing enteric uremic toxins via excretion will lead to continuous, steady removal of nitrogenous waste metabolites and as such help the whole system to function better.
“When undergoing treatment, nephrologists normally focus on treating the symptoms but less so the cause – that’s what we aim to do with the overarching aim of restoring good quality of life for the patients,” he said.
He added that probiotics can help to do this in several ways.
“The first is via an antibiotic-like effect from bacteriocins produced by the probitoics, which act to decrease bad bacteria levels. It can also reduce the amount of toxins such as uremic toxins and gut-generated toxins.
“In addition, probiotics also have beneficial effects on inflammation control, as well as on health aspects such as cholesterol and lactose tolerance.”
Enteric dialysis for higher quality of life
Dr Ranganathan referred to the consumption of Kibow Biotech’s oral probiotic with specific uremic toxin removal capabilities targeted at kidney disease as a concept termed ‘Enteric Dialysis’.
“With enteric dialysis, there is no need for surgical procedures or any other invasive intervention, there are no chances of infection, and no dietary restriction are required either, in contrast with peritoneal or hemo-dialysis,” Dr Ranganathan said.
“The key thing here is that the patients’ quality of life will be improved, whether in terms of mood, energy or fitness, and consumer surveys have confirmed this.”
Important probiotic bacterial strains that he highlighted as part of the oral probiotic formulation included Streptococcus thermophilus, Lactobacillus acidophilus and Bifidobacteria longum.