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Microbiota issue in CKD: how promising are gut-targeted approaches?
- Source :
- Journal of Nephrology. 32:27-37
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- In chronic kidney disease (CKD), the progressive decline in the renal excretory function leads to accumulation of urea and toxins in the blood. The CKD-associated dysbiosis of gut microbiota further contributes to uremia by increasing intestinal toxins production. Gut microbiota is involved in a complex network of human organs, mediated by microbial metabolites: in CKD, gut-heart and gut-brain axes may have a role in increased cardiovascular risk and neuropsychiatric disorders. While the cardiovascular toxicity of some microbial molecules is well known, their presumptive neurotoxicity needs to be confirmed by specific studies. In this review, we describe gut-heart and gut-brain axes in CKD, with an overview of the experimental and human studies characterizing CKD-associated gut microbiota, and we discuss the benefits coming from new approaches aimed at gut manipulation. Microbiota metabolism is emerging as a modifiable non-traditional risk factor in nephrology. In order to take advantage of this issue, it is necessary to consider the microbiota manipulation as part of the nutritional management of CKD. Integrating the low-protein nutritional approach with prebiotic, probiotic and synbiotic supplementation is a promising tool to control disease progression and comorbidities, though an extensive validation in large-scale clinical trials is still required.
- Subjects :
- Nephrology
medicine.medical_specialty
medicine.medical_treatment
Gut–brain axis
030232 urology & nephrology
Synbiotics
030204 cardiovascular system & hematology
Gut flora
Kidney
urologic and male genital diseases
Bioinformatics
Cardiovascular System
digestive system
law.invention
03 medical and health sciences
Probiotic
0302 clinical medicine
law
Internal medicine
Diet, Protein-Restricted
medicine
Animals
Humans
Urea
Renal Insufficiency, Chronic
Uremia
Bacteria
biology
business.industry
Probiotics
Prebiotic
Brain
medicine.disease
biology.organism_classification
Gastrointestinal Microbiome
Intestines
Renal Elimination
Prebiotics
Host-Pathogen Interactions
Dysbiosis
business
Kidney disease
Subjects
Details
- ISSN :
- 17246059 and 11218428
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....93e6c53fb0a9d3c523c4c89962258b09