Therapeutic Clinical Implications of Crosstalk amongst Gut Microbiota, Bone Health and Vascular Calcification in Chronic Kidney Disease: A Narrative Review

Abstract

Earlier we had reviewed the part of epigenetic modifications in Diabetic Kidney Disease (DKD), other etiological factors in Chronic Kidney Disease (CKD) besides role of bilirubin in DKD, role of probiotics and prebiotics in obesity, T2DM, NAFLD. Here our objective was to evaluate the part of gut microbiota (GM), bone health and vascular calcification in CKD in this Narrative Review’. Decontrolling of GM might possess part in vascular along with bone disease in case of CKD randomized trial particular. With the reduction in glomerular filtration rate (GFR), escalated production of urea as well as uric acid ensues along with bacterial proteolytic fermentation changes the gut microbiome balance. Diets possessing lesser quantities of fibers along with utilization of medicines like Vitamin K antagonists as well as phosphate binders, iron delivery, antibiotics further aid in alterations in GM diversity in case of CKD patients. Simultaneously both bone disease along with vascular disease usually accompany CKD. Thus here we concentrate on gut dysbiosis, vascular calcification bone demineralization in addition to their interdependence namely the Gut- vascular -bone-axis in CKD is getting validated with greater proof. The part of diet metabolites of gut microbial origin like p-cresyl sulfate, Indoxyl sulfate, Trimethylamine-N-oxide(TMAO), short chain fatty acids(SCFA) Vitamin K deficiency, inflammatory cytokines expression are detailed. This interdependence might open up innovative avenues regarding treatment as well as avoidance for enhancement of cardiovascular along with bone health. Various studies are trying to find the appropriate utilization of various Probiotics as well as Prebiotics supplementation without escalation of inimical actions.