Link between gut microbiota dysbiosis and chronic kidney disease
A. Noce, M. Marchetti, G. Marrone, L. Di Renzo, M. Di Lauro, F. Di Daniele, M. Albanese, N. Di Daniele, A. De Lorenzo Department of Systems Medicine, UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, University of Rome Tor Vergata, Rome, Italy. annalisa.noce@uniroma2.it
During chronic kidney disease (CKD), typical alterations in the gut microbiota are observed. The kidney no longer plays the role of the main excretory organ as this function is performed by the intestine. In CKD patients, an alteration of intestinal permeability and a degradation of the protective mucous layer are observed. These changes in the intestinal barrier allow the passage of bacterial material from the intestine to the bloodstream through the intestinal wall. This phenomenon contributes to the induction of the chronic inflammatory state, typical of CKD. In nephropathic patients, there is an increase in circulation of p-cresyl sulfate (p-CS), indoxyl sulphate (IS), indole-3 acetic acid (IAA) and trimethylamine-N-oxide (TMAO), all gut-derived uremic toxins. The changes in gut microbiota composition are related to CKD stage and this phenomenon is exacerbated in hemodialysis (HD) adult and pediatric patients. Interestingly, it is observed a positive shift in gut microbiota composition after renal transplantation and at the same time a reduction of circulating gut-derived uremic toxins. Either gut dysbiosis or uremic toxins accumulation contribute to the CKD onset and progression.
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To cite this article
A. Noce, M. Marchetti, G. Marrone, L. Di Renzo, M. Di Lauro, F. Di Daniele, M. Albanese, N. Di Daniele, A. De Lorenzo
Link between gut microbiota dysbiosis and chronic kidney disease
Eur Rev Med Pharmacol Sci
Year: 2022
Vol. 26 - N. 6
Pages: 2057-2074
DOI: 10.26355/eurrev_202203_28354