Li Cheng, Chen Xulong, Zha Weiwei, Fang Sitian, Shen Jiangwen, Li Lin, Jiang Hongli, Tian PuXun
Department of Kidney Transplantation, Nephropathy Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaan'xi, China.
Institute of Organ Transplantation, Xi'an Jiaotong University, Xi'an, Shaan'xi, China.
Ren Fail. 2025 Dec;47(1):2506810. doi: 10.1080/0886022X.2025.2506810. Epub 2025 May 29.
Chronic kidney disease (CKD) poses a severe health risk with high morbidity and mortality, profoundly affecting patient quality of life and survival. Despite advancements in research, the pathophysiology of CKD remains incompletely understood. Growing evidence links CKD with shifts in gut microbiota function and composition. Natural compounds, particularly polyphenols, have shown promise in CKD treatment due to their antioxidant and anti-inflammatory properties and their ability to modulate gut microbiota. This review discusses recent progress in uncovering the connections between gut microbiota and CKD, including microbiota changes across different kidney diseases. We also examine metabolite alterations,such as trimethylamine-N-oxide, tryptophan derivatives, branched-chain amino acids, short-chain fatty acids, and bile acids,which contribute to CKD progression. Further, we outline the mechanisms through which polyphenols exert therapeutic effects on CKD, focusing on signaling pathways like nuclear factor kappa-B (NF-κB), mitogen-activated protein kinase (MAPK), mammalian target of rapamycin (mTOR), NOD-like receptor thermal protein domain associated protein 3 (NLRP3), phosphatidylin-ositol-3-kinase (PI3K)/protein kinase B (Akt), and toll like receptors (TLR), as well as their impact on gut microbiota. Lastly, we consider how dietary polyphenols could be harnessed as bioactive drugs to slow CKD progression. Future research should prioritize multi-omics approaches to identify patients who would benefit from polyphenolic interventions, enabling personalized treatment strategies to enhance therapeutic efficacy.
慢性肾脏病（CKD）具有高发病率和死亡率，对健康构成严重风险，深刻影响患者的生活质量和生存期。尽管研究取得了进展，但CKD的病理生理学仍未完全明确。越来越多的证据表明CKD与肠道微生物群功能和组成的变化有关。天然化合物，特别是多酚，因其抗氧化和抗炎特性以及调节肠道微生物群的能力，在CKD治疗中显示出前景。本综述讨论了在揭示肠道微生物群与CKD之间联系方面的最新进展，包括不同肾脏疾病中微生物群的变化。我们还研究了代谢物的改变，如氧化三甲胺、色氨酸衍生物、支链氨基酸、短链脂肪酸和胆汁酸，这些物质会促进CKD的进展。此外，我们概述了多酚对CKD发挥治疗作用的机制，重点关注核因子κB（NF-κB）、丝裂原活化蛋白激酶（MAPK）、雷帕霉素靶蛋白（mTOR）、NOD样受体热蛋白结构域相关蛋白3（NLRP3）、磷脂酰肌醇-3-激酶（PI3K）/蛋白激酶B（Akt）和Toll样受体（TLR）等信号通路，以及它们对肠道微生物群的影响。最后，我们考虑如何将膳食多酚作为生物活性药物来减缓CKD的进展。未来的研究应优先采用多组学方法来确定能从多酚干预中获益的患者，从而制定个性化治疗策略以提高治疗效果。
