Ondrussek-Sekac Mateo, Navas-Carrillo Diana, Orenes-Piñero Esteban
Department of Biochemistry and Molecular Biology-A, University of Murcia, Murcia, Spain.
Department of Surgery, Hospital de la Vega HLA, Murcia, Spain.
Crit Rev Food Sci Nutr. 2021;61(9):1490-1502. doi: 10.1080/10408398.2020.1761771. Epub 2020 May 12.
In chronic kidney disease, as in many other diseases, dysbiosis of intestinal microbiota has been reported as a disturbance or imbalance of the normal microbiome content that could disrupt the symbiotic relationship between the host and associated microbes, a disruption that can result in diseases. The disruption of gut barrier function allows the translocation of endotoxins and bacterial metabolites to the organism, thus contributing to uremic toxicity, inflammation and progression of chronic kidney disease. Increased intake of some nutrients and different nutritional strategies have been proposed to modulate gut microbiota, thus offering the opportunity for therapeutic interventions modifying the diet, decreasing uremic toxins production, increasing toxin excretion and finally modifying the normal microbiome content. The use of probiotics, prebiotics and low protein diets, among other approaches, could also improve this imbalance and/or decrease permeability of the intestinal barrier. In this review, the link between nutrients, microbiota and uremic toxins with chronic kidney disease progression has been studied thoroughly. Furthermore, this review outlines potential mechanisms of action and efficacy of probiotics, prebiotics and low protein diets as a new chronic kidney disease management tool.
与许多其他疾病一样，在慢性肾脏病中，肠道微生物群失调被认为是正常微生物组含量的紊乱或失衡，这可能会破坏宿主与相关微生物之间的共生关系，而这种破坏会导致疾病。肠道屏障功能的破坏使内毒素和细菌代谢产物易位至机体，从而导致尿毒症毒性、炎症及慢性肾脏病进展。有人提出增加某些营养素的摄入量并采用不同的营养策略来调节肠道微生物群，从而为通过调整饮食进行治疗干预、减少尿毒症毒素产生、增加毒素排泄并最终改变正常微生物组含量提供了机会。使用益生菌、益生元及低蛋白饮食等方法，也可以改善这种失衡和/或降低肠道屏障的通透性。在本综述中，对营养素、微生物群和尿毒症毒素与慢性肾脏病进展之间的联系进行了深入研究。此外，本综述概述了益生菌、益生元及低蛋白饮食作为一种新型慢性肾脏病管理工具的潜在作用机制和疗效。
