Abstract
The incidence of CKD seriously endangers people's health. Researchers have proposed that improving the intestinal barrier damage in CKD may be an effective target for delaying the progression of CKD. Rhubarb can effectively improve the intestinal barrier and renal fibrosis, which may be related to the regulation of gut dysbiosis, but the mechanism needs to be further studied. Short-chain fatty acids (SCFAs) are important metabolites of the gut microbiota and play an important role in maintaining the intestinal barrier. The purpose of this study was to investigate whether rhubarb enema regulates the production of short-chain fatty acid-related gut microbiota and improves the intestinal barrier damage of CKD. 5/6 nephrectomy rats were used as the animal model, sevelamer was used as the positive control group, and the sham operation rats were used as the control group. After 4 weeks of enema treatment, the general clinical indicators, short-chain fatty acid levels, renal pathology, intestinal tissue pathology, intestinal tight junction protein, and changes in gut microbiota were detected. The results showed that rhubarb enema can increase the level of short-chain fatty acids in the 5/6 nephrectomy model rats, improve the intestinal barrier damage, inhibit the decrease of intestinal tight junction proteins, reduce inflammation levels, improve kidney pathology, reduce blood creatinine levels, and regulate the intestinal tract, the abundance, and composition of the flora. Further correlation analysis showed that rhubarb enema increased the level of short-chain fatty acids in 5/6 nephrectomy model rats, which may be related to the 7 strains that may regulate the production of short-chain fatty acids. This study indicated that rhubarb enema can improve the intestinal barrier damage of 5/6 nephrectomy model rats and improve CKD, which may be related to the regulation of short-chain fatty acid-producing gut microbiota.
Highlights
Chronic kidney disease (CKD) is a disease in which the development of chronic kidney structural damage and dysfunction caused by various reasons can lead to chronic renal failure (CRF)
More than 850 million people in the world suffer from chronic kidney disease, of which 5– 10 million are end-stage patients [1], which seriously endangers people’s lives and health
The international nephrology communities have been committed to exploring the risk factors of CKD progression and new methods to alleviate the progression of CKD
Summary
Chronic kidney disease (CKD) is a disease in which the development of chronic kidney structural damage and dysfunction caused by various reasons can lead to chronic renal failure (CRF). Recent studies have found that in the state of CKD, the disorder of the intestinal flora produces a variety of metabolic toxins, which enter the circulation through the injured intestinal barrier to promote cardiovascular and kidney damage [2], further aggravating the progression of CKD and is closely related to poor clinical prognosis [3]. BioMed Research International connections between the intestine and the kidney, the “gutkidney axis” theory has been formed [4]. It has become the focus of research in nephrology circles in recent years. The intestinal barrier is one of the key links in this theory, and there is still a lack of research on the treatment of CKD intestinal barrier injury
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