Gut microbiome and kidney disease: a bidirectional relationship

Abstract

Recent technological advances and efforts, including powerful metagenomic and metatranscriptomic analyses, have led to a tremendous growth in our understanding of microbial communities. Changes in microbial abundance or composition of human microbial communities impact human health or disease state. However, explorations into the mechanisms underlying host–microbe interactions in health and disease are still in their infancy. Although changes in the gut microbiota have been described in patients with kidney disease, the relationships between pathogenesis, mechanisms of disease progression, and the gut microbiome are still evolving. Here, we review changes in the host–microbiome symbiotic relationship in an attempt to explore the bidirectional relationship in which alterations in the microbiome affect kidney disease progression and how kidney disease may disrupt a balanced microbiome. We also discuss potential targeted interventions that may help re-establish this symbiosis and propose more effective ways to deploy traditional treatments in patients with kidney disease.

The effects of probiotics on renal function and uremic toxins in patients with chronic kidney disease; a meta-analysis of randomized controlled trials

“…Studies have also demonstrated the important role of intestinal dysbiosis in renal physiology and pathophysiology (22,23) such as accumulation of uremic toxins, systemic inflammation, and infection, which all may contribute to the development of CKD, its progression, and its complications (22,(24)(25)(26)(27)(28)(29). Restoration of microbiome diversity by administration of probiotics may provide beneficial effects on kidneys (25,(30)(31)(32)(33). This has been shown in uremic rats and kidney ischemia reperfusion injury models (34)(35)(36)(37).…”

“…Intestinal dysbiosis, an imbalance between pathogenic and protective microbiota, has been associated with a variety of health conditions including Clostridium difficile (16,17), Crohn's disease (18,19), non-alcoholic steatohepatitis (NASH) (20), and systemic inflammation (21). Studies have also demonstrated the important role of intestinal dysbiosis in renal physiology and pathophysiology (22,23) such as accumulation of uremic toxins, systemic inflammation, and infection, which all may contribute to the development of CKD, its progression, and its complications (22,(24)(25)(26)(27)(28)(29). Restoration of microbiome diversity by administration of probiotics may provide beneficial effects on kidneys (25,(30)(31)(32)(33).…”

Differential Effect of Sucrose and Fructose in Combination with a High Fat Diet on Intestinal Microbiota and Kidney Oxidative Stress

“…Kidney disease is associated with low fiber consumption and increased intestinal permeability due to a modified intestinal microbiota [5]. During obesity there is an inflammatory state and imbalance in the gut microbiota composition (dysbiosis) involving the toll-like receptor (TLR) family.…”

The Cardiovascular Burden in End-Stage Renal Disease

“…The adult gut is dominated by 2 bacterial phyla, the Gram-negative Bacteroides and the Gram-positive Firmicutes. The gut microbiota has a central role in the metabolism of dietary fibers, which are not degraded by human enzyme; furthermore, it plays a role in the stimulation of the immune system, maintenance of intestinal epithelium homeostasis, synthesis of vitamins, enhancement of gastrointestinal motility and function, production of short-chain fatty acids, and polyamines [39] . Also, the gastrointestinal system is the interface between the blood and the potentially toxic contents of the gut.…”