Gut Dysbiosis and Kidney Diseases.

Chujin Cao,Ying Yao,Rui Zeng,Han Zhu

doi:10.3389/fmed.2022.829349

Chujin Cao, Ying Yao + Show 2 more

Open Access

https://doi.org/10.3389/fmed.2022.829349

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Abstract

Gut dysbiosis is defined as disorders of gut microbiota and loss of barrier integrity, which are ubiquitous on pathological conditions and associated with the development of various diseases. Kidney diseases are accompanied with gut dysbiosis and metabolic disorders, which in turn contribute to the pathogenesis and progression of kidney diseases. Microbial alterations trigger production of harmful metabolites such as uremic toxins and a decrease in the number of beneficial ones such as SCFAs, which is the major mechanism of gut dysbiosis on kidney diseases according to current studies. In addition, the activation of immune responses and mitochondrial dysfunction by gut dysbiosis, also lead to the development of kidney diseases. Based on the molecular mechanisms, modification of gut dysbiosis via probiotics, prebiotics and synbiotics is a potential approach to slow kidney disease progression. Fecal microbiota transplantation (FMT) and genetic manipulation of the gut microbiota are also promising choices. However, the clinical use of probiotics in kidney disease is not supported by the current clinical evidence. Further studies are necessary to explore the causal relationships of gut dysbiosis and kidney diseases, the efficiency and safety of therapeutic strategies targeting gut-kidney axis.

Highlights

Kidney disease is a major public health concern worldwide and is associated with the high morbidity and mortality, with the various pathogenic mechanisms related to immune responses, oxidative stress, inflammation, metabolic disturbance and so on [1–5]
We described that gut dysbiosis existed in various kidney diseases, generally manifesting as imbalance between beneficial bacteria and pathogenic bacteria
Gut dysbiosis was accompanied by metabolic disorders, which were the important mediators in gut-kidney axis

Summary

Introduction

Kidney disease is a major public health concern worldwide and is associated with the high morbidity and mortality, with the various pathogenic mechanisms related to immune responses, oxidative stress, inflammation, metabolic disturbance and so on [1–5]. How to slow the progression of chronic kidney disease (CKD) is tough due to the current therapeutic strategies just aiming at the decrease on proteinuria and the control of elevated blood pressure [6]. Bacteria are one of microorganisms and classified on the level of phyla, classes, orders, families, genera, and species. The dominant bacteria on phylum level are Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria, and Verrucomicrobia. Firmicutes and Bacteroidetes predominate and represent 90% of the bacteria in gut [8]. Gut microbiota variations tend to be one of the important implications in intestinal and extra-intestinal disorders. These variations are defined as gut dysbiosis, which includes disorders of

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