Saranya G R, Viswanathan Pragasam
Renal Research Lab, School of Bio Sciences and Technology, Pearl Research Park, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India.
Renal Research Lab, School of Bio Sciences and Technology, Pearl Research Park, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India.
Biomed Pharmacother. 2023 May;161:114447. doi: 10.1016/j.biopha.2023.114447. Epub 2023 Mar 1.
The symptoms of acute kidney injury (AKI) include a sudden drop-in glomerular filtration rate (GFR), a rise in serum creatinine (sCr), blood urea nitrogen (BUN), and electrolytes, which leads to a rapid loss of kidney function. Chronic kidney disease progresses when AKI symptoms persist for over three months or 90 days. Numerous prevalent secondary risk factors, including diabetes, hypertension, obesity, and heart illness, are directly or indirectly linked to the development of AKI and the switch from AKI to CKD. Recently, the change of intestinal bacteria known as "gut dysbiosis" has been linked to distant organ dysfunction, including the heart, lungs, kidneys, and brain. Indirectly or directly, gut dysbiosis contributes to the progression of CKD and AKI. However, the effects of gut dysbiosis and the mechanism of action in the progression from AKI to CKD are unknown or need further investigation. The mechanism by which gut dysbiosis initiates AKI's progression to CKD should be explicitly concerned. The review primarily focuses on the action of gut dysbiosis in kidney disease, the effects of dysbiosis, the characterisation of dysbiosis and its pathogenic products, the various pathogenic routes and mechanism involved in expediting the transition from AKI to CKD.
We identified and briefly reviewed the impacts of dysbiosis in various situations such as hypoxia, mitochondrial induced reactive oxygen species (mtROS), aryl hydrocarbon receptor (AhR) activation and microbiota derived uremic toxemic substances profoundly to push AKI to CKD conditions.
急性肾损伤(AKI)的症状包括肾小球滤过率(GFR)突然下降、血清肌酐(sCr)、血尿素氮(BUN)和电解质升高,这会导致肾功能迅速丧失。当AKI症状持续超过三个月或90天时,慢性肾脏病就会进展。许多常见的次要危险因素,包括糖尿病、高血压、肥胖和心脏病,都直接或间接与AKI的发生以及从AKI向CKD的转变有关。最近,被称为“肠道菌群失调”的肠道细菌变化与包括心脏、肺、肾脏和大脑在内的远处器官功能障碍有关。肠道菌群失调直接或间接地促进了CKD和AKI的进展。然而,肠道菌群失调的影响以及在从AKI进展到CKD过程中的作用机制尚不清楚或需要进一步研究。应明确关注肠道菌群失调引发AKI进展为CKD的机制。本综述主要关注肠道菌群失调在肾脏疾病中的作用、失调的影响、失调及其致病产物的特征、加速从AKI转变为CKD的各种致病途径和机制。
我们识别并简要回顾了菌群失调在各种情况下的影响,如缺氧、线粒体诱导的活性氧(mtROS)、芳烃受体(AhR)激活以及微生物群衍生的尿毒症毒性物质,这些因素会深刻地促使AKI发展为CKD。