Application of Probiotics Consumption in Patients With Kidney and Urinary Tract Diseases; a Systematic Review of Clinical Evidence and Mechanistic Insights Publisher



Montazeri P ; Rezakhaniha B ; Dialameh H ; Sadeghi S ; Gerami R ; Namdari F
Source: Journal of Nephropharmacology Published:2026

Abstract

Introduction: Kidney and urinary tract diseases pose a significant health burden, and probiotics, by modulating gut and urogenital microbiota, may offer supportive benefits in this field. This review systematically evaluates the current literature to clarify the role of probiotic consumption in nephrology and urology. Materials and Methods: A systematic review was conducted in accordance with PRISMA guidelines, with comprehensive searches performed in PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar from inception to December 2025 without language restrictions; search strategies combined MeSH terms and keywords for probiotics, kidney diseases, and urinary tract infections (UTIs) using Boolean operators, and additional studies were identified through manual reference list searches; two independent reviewers screened titles, abstracts, and full texts against predefined criteria, extracted data using a standardized form, and assessed methodological quality with the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle–Ottawa Scale for observational studies. Results: This systematic review of 16 randomized and cross-sectional studies involving 2,667 participants across 12 countries found that probiotics may offer therapeutic benefits in kidney and urinary tract diseases. In chronic kidney disease (CKD) populations, probiotics showed potential in reducing uremic toxins, improving glycemic control, lowering inflammation, and enhancing quality of life, though some studies reported neutral or adverse effects, such as increased interleukin 6 (IL-6) or uremic markers in dialysis patients. In UTI, Lactobacillus-based probiotics were generally safe and effective in reducing recurrence, improving outcomes when combined with antibiotics, and lowering bacterial resistance, although certain strains demonstrated limited or no benefit. Conclusion: In conclusion, probiotics may serve as a safe adjunctive therapy in kidney and urinary tract diseases, but strain- and patient-specific responses as well as optimal formulations, dosing, and long-term effects require confirmation through larger, well-designed trials. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251273335) and the Research Registry (UIN: reviewregistry2068) websites. Copyright © 2026 The Author(s); Published by Society of Diabetic Nephropathy Prevention. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.