Chronic Kidney Disease and Gut Microbiota: What Is Their Connection in Early Life?

Area of Science:

• Microbiology
• Nephrology
• Pediatrics

Background:

• The gut-kidney axis is increasingly recognized for its role in chronic kidney disease (CKD).
• CKD can have origins in early life, necessitating early intervention strategies.
• Understanding the early-life gut microbiome's impact on later-life CKD is a critical unmet need.

Purpose of the Study:

• To review evidence on gut microbiota dysbiosis in pediatric CKD.
• To summarize the gut-kidney axis's impact on CKD, including inflammation, immune response, microbiota composition, short-chain fatty acids, and uremic toxins.
• To overview early gut microbiota-targeted interventions in animal models of developmental origins of CKD.

Main Methods:

• Literature review of studies on pediatric CKD and gut microbiota.
• Analysis of research on the gut-kidney axis mechanisms in CKD.
• Examination of preclinical studies on early-life gut microbiota interventions.

Main Results:

• Gut microbiota dysbiosis is implicated in pediatric CKD.
• The gut-kidney axis influences CKD through inflammation, immune responses, microbial alterations, SCFAs, and uremic toxins.
• Early interventions like prebiotics, probiotics, and postbiotics show promise in animal models.

Conclusions:

• Targeting the gut microbiome in early life offers a potential strategy for CKD prevention.
• Further research and clinical translation are needed to develop effective gut microbiota-based therapies for pediatric CKD.
• A deeper understanding of gut dysbiosis in renal programming is essential for advancing early CKD prevention.