title: The microbiota and chronic kidney diseases: a double-edged sword.
abstract: Recent findings regarding the influence of the microbiota in many inflammatory processes have provided a new way to treat diseases. Now, one may hypothesize that the origin of a plethora of diseases is related to the health of the gut microbiota and its delicate, although complex, interface with the epithelial and immune systems. The 'westernization' of diets, for example, is associated with alterations in the gut microbiota. Such alterations have been found to correlate directly with the increased incidence of diabetes and hypertension, the main causes of chronic kidney diseases (CKDs), which, in turn, have a high estimated prevalence. Indeed, data have arisen showing that the progression of kidney diseases is strictly related to the composition of the microbiota. Alterations in the gut microbiota diversity during CKDs do not only have the potential to exacerbate renal injury but may also contribute to the development of associated comorbidities, such as cardiovascular diseases and insulin resistance. In this review, we discuss how dysbiosis through alterations in the gut barrier and the consequent activation of immune system could intensify the progression of CKD and vice versa, how CKDs can modify the gut microbiota diversity and abundance.
authors.affiliation: Laboratory of Clinical and Experimental Immunology, Nephrology Division, Federal University of São Paulo , São Paulo, Brazil.
authors.forename: Raphael Jose Ferreira
authors.initials: RJ
authors.lastname: Felizardo
authors.affiliation: Department of Immunology, Laboratory of Transplantation Immunobiology, Institute of Biomedical Sciences IV, University of São Paulo , São Paulo, Brazil.
authors.forename: Angela
authors.initials: A
authors.lastname: Castoldi
authors.affiliation: Department of Immunology, Laboratory of Transplantation Immunobiology, Institute of Biomedical Sciences IV, University of São Paulo , São Paulo, Brazil.
authors.forename: Vinicius
authors.initials: V
authors.lastname: Andrade-Oliveira
authors.affiliation: Laboratory of Clinical and Experimental Immunology, Nephrology Division, Federal University of São Paulo, São Paulo, Brazil; Department of Immunology, Laboratory of Transplantation Immunobiology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil; Department of Medicine, Laboratory of Renal Physiology (LIM 16), University of São Paulo, São Paulo, Brazil.
authors.forename: Niels Olsen Saraiva
authors.initials: NO
authors.lastname: Câmara