Nonextracorporeal methods for decreasing uremic solute concentration: a future way to go?
The uremic milieu is consequential to a disrupted balance between availability of retention solutes and the excretory capacity of the kidneys. Although metabolism is the prime contributor to the internal milieu, a significant fraction of uremic retention solutes originates from other sources. The main route of entrance is via the intestinal tract, directly from the diet and indirectly from commensal microbial metabolism. This latter dynamic interplay between the intestines and kidney has been coined the gut-kidney axis. This review summarizes current understanding of the gut-kidney axis and explores the impact of dietary and other nonextracorporeal therapeutic interventions in patients with chronic kidney disease.
Department of Nephrology, University Hospitals Leuven, Leuven, Belgium; Department of Immunology and Microbiology, KU Leuven, Leuven, Belgium. Electronic address: Bjorn.meijers@uzleuven.be.
Björn
B
Meijers
Nephrology Section, Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium.
Griet
G
Glorieux
Department of Nephrology, University Hospitals Leuven, Leuven, Belgium; Department of Immunology and Microbiology, KU Leuven, Leuven, Belgium.
Ruben
R
Poesen
Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
Stephan J L
SJ
Bakker
D005544:Forecasting; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism*; D051436:Renal Insufficiency, Chronic / Q000178:diet therapy* / Q000188:drug therapy* / Q000378:metabolism; D014511:Uremia / Q000178:diet therapy* / Q000188:drug therapy* / Q000378:metabolism
Uremic retention solutes; diet; intestine; metabolism; microbiome