Is resistant starch beneficial in chronic kidney disease?

Chronic kidney disease (CKD) is associated with alterations of the gut microbiome, sometimes referred to as dysbiosis. These changes may include reductions in the bacterial species involved in SCFA production and increases in bacterial enzymes involved in the production of uremic toxins (substances that can build up in the body of people with CKD).^[1] Because of this, RS has been a supplement of interest given its ability to modulate the microbiome and increase the production of SCFAs in some people. In a 2022 meta-analysis of randomized controlled trials, RS supplementation was found to reduce blood levels of indoxyl sulfate (a uremic toxin associated with worse health outcomes in CKD),^[2] phosphorus, interleukin-6, and uric acid in people with CKD undergoing dialysis.^[3] While this is promising, it is unclear whether these beneficial effects lead to any meaningful changes in health outcomes, and further research is required.