Gut Microbiome in Chronic Kidney Disease.
With over 100 trillion microbial cells, the gut microbiome plays important roles in both the maintenance of health and the pathogenesis of disease. Gut microbiome dysbiosis, resulted from alteration of composition and function of the gut microbiome and disruption of gut barrier function, is commonly seen in patients with chronic kidney disease (CKD). The dysbiotic gut microbiome generates excessive amounts of uremic toxins, and the impaired intestinal barrier permits translocation of these toxins into the systemic circulation. Many of these uremic toxins have been implicated in the progression of CKD and increased cardiovascular risk. Various therapeutic interventions have been proposed that aim to restore gut microbiome symbiosis. If proven effective, these interventions will have a significant impact on the management of CKD patients. In this review, we discuss the consequences of gut microbiome dysbiosis in the context of CKD, discuss the consequences of gut dysbiosis, and highlight some of the recent interventions targeting the gut microbiome for therapeutic purposes.
Nephrology Division, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.
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Armani
Division of Renal Diseases and Hypertension, The George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.
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Ramezani
Division of Renal Diseases and Hypertension, The George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.
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Yasir
Division of Renal Diseases and Hypertension, The George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.
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Sharama
Nephrology Division, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil.|Division of Renal Diseases and Hypertension, The George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA.
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Canziani
Division of Renal Diseases and Hypertension, The George Washington University School of Medicine, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA. draj@mfa.gwu.edu.
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Raj
D000818:Animals; D002318:Cardiovascular Diseases; D018450:Disease Progression; D000069196:Gastrointestinal Microbiome; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy; D012307:Risk Factors
Cardiovascular disease; Chronic kidney disease; Dysbiosis; Microbiome; Uremic toxin