Insights into the gut-kidney axis and implications for chronic kidney disease management in cats and dogs.

Chronic kidney disease (CKD) in cats and dogs presents significant clinical challenges, with emerging research highlighting the pivotal role of the gut-kidney axis in its pathogenesis and management. Gut dysbiosis, characterized by alterations in the gut microbiome composition and function, contributes to microbial dysmetabolism of key nutrients causing uremic toxin accumulation and disruptions in amino acid, bile acid and fatty acid profiles. These disturbances in turn exacerbate renal dysfunction and systemic inflammation. Recent research in veterinary medicine, particularly in cats, supports the gut microbiome and microbial-derived metabolites as novel therapeutic targets. Potential therapeutic strategies targeting the gut microbiome and microbial dysmetabolism, including dietary management, probiotics, adsorbents, and addressing constipation, offer promising avenues for intervention to restore metabolic balance and preserve renal function. This review highlights the microbial influence on renal health and focuses on potential therapeutic strategies available to veterinarians to optimize the management of CKD in cats and dogs.
Competing Interests: Conflict of Interest Dr Quimby: Advisory board for Nestle Purina PetCare; speaker honoraria Dechra, Elanco, Heska, Nestle Purina Petcare, Royal Canin; Consulting, BI, Dechra, Elanco, Gallant, Hill’s, Kidney-Chek, Vetoquinol; Research funding from Dechra, Nestle Purina Petcare, Triviumvet, Zoetis; Member of the International Renal Interest Society Board. Dr. Summers: Speaker honoraria Boehringer-Ingelheim, Royal Canin, Dechra and research consultant for IDEXX Laboratories Inc and Nestle Purina.
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