Ghajarzadeh-Wurzner Arlène, Berney Maxime, Teta Daniel, Genton Laurence, Pruijm Menno
Service de néphrologie et d'hypertension, CHUV, 1011 Lausanne.
Service de néphrologie, Centre hospitalier du Valais romand (CHVR), Hôpital de Sion, 1951 Sion.
Rev Med Suisse. 2018 Feb 21;14(595):422-425.
Recent studies have found a relationship between the kidney and the intestinal microbiome, called the colo-renal axis. Mounting evidence suggests that patients suffering from chronic kidney disease (CKD) have an altered composition of gut microbiota. This leads to 1) the increased fermentation of intestinal proteins to uremic toxins such as p-cresyl sulphate and indoxyl sulphate, 2) an altered, more 'leaky' intestinal barrier, and 3) translocation of bacteria and toxins from the gut lumen to the circulation, inducing systemic inflammation. This may contribute to the increased morbidity and mortality in this population. Future studies are needed to confirm this hypothesis, and to assess whether manipulating the intestinal microbiota with pre-, pro-, or symbiotics may alter the development and course of CKD.
最近的研究发现肾脏与肠道微生物群之间存在一种关系，称为结肠-肾轴。越来越多的证据表明，患有慢性肾脏病（CKD）的患者肠道微生物群的组成发生了改变。这导致：1）肠道蛋白质发酵增加，产生诸如对甲酚硫酸盐和吲哚硫酸盐等尿毒症毒素；2）肠道屏障改变，变得更“渗漏”；3）细菌和毒素从肠腔转移至循环系统，引发全身炎症。这可能导致该人群发病率和死亡率增加。未来需要开展研究来证实这一假设，并评估使用益生元、益生菌或合生元来调节肠道微生物群是否可能改变CKD的发展和进程。
