Zhang Yujie, Qing Jianbo, Saed Yasin Abdi, Li Yafeng
School of Pharmaceutical Science, Sun Yat-Sen University, Guangzhou, China.
Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ren Fail. 2025 Dec;47(1):2517402. doi: 10.1080/0886022X.2025.2517402. Epub 2025 Jun 25.
Diabetic kidney disease (DKD) is one of the leading causes of chronic kidney disease and end-stage renal disease worldwide, predominantly driven by the rise in type 2 diabetes mellitus. Recent evidence highlights the crucial role of gut microbiota dysbiosis in the development and progression of DKD. Dysbiosis, characterized by a reduction in beneficial short-chain fatty acid-producing bacteria and an increase in pathogenic species such as and , exacerbates systemic inflammation, insulin resistance, and kidney damage through mechanisms like increased intestinal permeability and the production of pro-inflammatory metabolites like lipopolysaccharides. This review explores the impact of specific bacterial taxa on DKD risk and progression, such as , , and their interactions with metabolic pathways. Furthermore, we discuss novel therapeutic strategies targeting gut microbiota, including probiotics, prebiotics, synbiotics, and fecal microbiota transplantation, which have shown promise in ameliorating DKD symptoms. However, the heterogeneity of gut microbiota across individuals and the challenges in treatment standardization call for personalized approaches and further research into the gut-kidney axis.
糖尿病肾病（DKD）是全球慢性肾脏病和终末期肾病的主要病因之一，主要由2型糖尿病的增加所致。最近的证据凸显了肠道微生物群失调在DKD发生和发展中的关键作用。失调的特征是产生有益短链脂肪酸的细菌减少，以及诸如[具体菌种1]和[具体菌种2]等致病菌种增加，通过肠道通透性增加和脂多糖等促炎代谢产物的产生等机制加剧全身炎症、胰岛素抵抗和肾脏损伤。本综述探讨了特定细菌类群对DKD风险和进展的影响，例如[具体细菌类群1]、[具体细菌类群2]及其与代谢途径的相互作用。此外，我们讨论了针对肠道微生物群的新型治疗策略，包括益生菌、益生元、合生元和粪便微生物群移植，这些策略在改善DKD症状方面已显示出前景。然而，个体间肠道微生物群的异质性以及治疗标准化方面的挑战需要个性化方法，并进一步研究肠道-肾脏轴。
