Gut microbiome in chronic kidney disease: challenges and opportunities

Abstract

More than 100 trillion microbial cells that reside in the human gut heavily influence nutrition, metabolism, and immune function of the host. Gut dysbiosis, seen commonly in patients with chronic kidney disease (CKD), results from qualitative and quantitative changes in host microbiome profile and disruption of gut barrier function. Alterations in gut microbiota and a myriad of host responses have been implicated in progression of CKD, increased cardiovascular risk, uremic toxicity, and inflammation. We present a discussion of dysbiosis, various uremic toxins produced from dysbiotic gut microbiome, and their roles in CKD progression and complications. We also review the gut microbiome in renal transplant, highlighting the role of commensal microbes in alteration of immune responses to transplantation, and conclude with therapeutic interventions that aim to restore intestinal dysbiosis.

Conflict of interest statement

of potential conflict of interest All authors have read the journal’s policy on disclosure of potential conflicts of interest and have nothing to disclose. All authors have read the journal’s authorship agreement and that the manuscript has been reviewed by and approved by all named authors.

Copyright © 2016 Elsevier Inc. All rights reserved.

Figures

Figure 1

Regulation of intestinal CD4+ T-cell by gut microbiota.

Figure 2

Schematic representation of origin and synthesis of the major uremic toxins from dysbiotic gut microbiome, subsequent modification in the liver, and secretion into the circulation.