Chronic kidney disease and dysbiosis: An overview of gut microbiota and uremic toxins.

Abstract

Background: Chronic kidney disease (CKD) is a highly prevalent condition with complications such as constipation, inflammation, and dietary restrictions. Gut microbiota is an ecosystem of trillions of bacteria and other microorganisms such as viruses, fungi, and other eukaryotes. This review aimed to analyze the correlation between CKD and the microbiota.

Materials and methods: This is a literature review of recent articles published in the Medline database.

Results: As CKD progresses, there is a change in the composition of the gut bacteria colonies, with the production of gut-derived uremic toxins. Gut-impaired permeability facilitates the bacteria fragments' translocation, increasing the stimulus for producing inflammatory mediators. Many interventions have been suggested to modulate the gut composition, and the administration of substances to interact with bacteria or decrease inflammatory status is of central interest. Probiotics are live microorganisms that interact with the local microbiota, and prebiotics are non-digested compounds that reach the colon. Their administration reduces the production of uremic toxins and inflammatory substances but fails to protect against chronic kidney disease progression.

Conclusion: Curcumin decreases uremic compounds and inflammation. Physical exercise did not act as a gut microbiota modulator. Systematic reviews and metanalysis evaluating gut microbiota modulators revealed a lack of positive impact on renal deterioration but a good reduction in the production of uremic toxins.