Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland.
Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland.
Int J Mol Sci. 2024 Sep 27;25(19):10429. doi: 10.3390/ijms251910429.
Chronic kidney disease (CKD) is a very prevalent and insidious disease, particularly with initially poorly manifested symptoms that progressively culminate in the manifestation of an advanced stage of the condition. The gradual impairment of kidney function, particularly decreased filtration capacity, results in the retention of uremic toxins and affects numerous molecular mechanisms within the body. The dysbiotic intestinal microbiome plays a crucial role in the accumulation of protein-bound uremic toxins such as p-cresol (pC), indoxyl sulfate (IS), and p-cresyl sulfate (p-CS) through the ongoing fermentation process. The described phenomenon leads to an elevated level of oxidative stress and inflammation, subsequently resulting in tissue damage and complications, particularly an increase in cardiovascular risk, representing the predominant cause of mortality in chronic kidney disease (CKD). Therefore, exploring methods to reduce uremic toxins is currently a pivotal therapeutic strategy aimed at reducing the risk of organ damage in patients with chronic kidney disease (CKD). This review aims to summarize recent discoveries on modifying the composition of the intestinal microbiota through the introduction of special probiotic and synbiotic supplements for CKD therapy. The potential to connect the gut microbiota with CKD opens the possibility for further extensive research in this area, which could lead to the incorporation of synbiotics and probiotics into the fundamental treatment and prevention of CKD.
慢性肾脏病（CKD）是一种非常普遍和隐匿的疾病，特别是最初症状表现不佳，逐渐发展到疾病的晚期阶段。肾功能的逐渐损害，特别是滤过能力的下降，导致尿毒症毒素的潴留，并影响体内许多分子机制。肠道微生物组的失调通过持续的发酵过程在蛋白质结合尿毒症毒素如对甲酚（pC）、吲哚硫酸（IS）和对甲酚硫酸盐（p-CS）的积累中起着关键作用。所述现象导致氧化应激和炎症水平升高，随后导致组织损伤和并发症，特别是心血管风险增加，这是慢性肾脏病（CKD）患者死亡的主要原因。因此，探索减少尿毒症毒素的方法是目前降低慢性肾脏病（CKD）患者器官损伤风险的关键治疗策略。本综述旨在总结通过引入特殊益生菌和共生元补充剂治疗 CKD 来改变肠道微生物群落组成的最新发现。将肠道微生物群与 CKD 联系起来为该领域的进一步广泛研究开辟了可能性，这可能导致将共生元和益生菌纳入 CKD 的基本治疗和预防中。
