Gut microbiota therapy for chronic kidney disease

Area of Science:

• Microbiology
• Nephrology
• Gastroenterology

Background:

• Chronic kidney disease (CKD) affects 13% of the global population and is increasingly associated with gut microbiota dysbiosis.
• Gut dysbiosis in CKD is driven by uremic toxins, metabolic changes, and diet, impacting disease progression.

Purpose of the Study:

• To review gut microbiota modulation as a therapeutic strategy for alleviating CKD symptoms.
• To explore interventions targeting gut microbiota composition and function in CKD.

Main Methods:

• Review of existing literature on prebiotics (e.g., resistant starch), dietary adjustments (low-protein, gluten-free), fecal microbiota transplantation (FMT), synbiotics, probiotics, and other interventions.
• Analysis of studies investigating the impact of these interventions on uremic toxins, inflammation, microbial diversity, renal biomarkers, and clinical outcomes.
• Consideration of emerging strategies like phage therapy and AI-driven multi-omics.

Main Results:

• Prebiotics and dietary changes show promise in reducing uremic toxins and inflammation, and improving renal biomarkers.
• Fecal microbiota transplantation (FMT) stabilizes creatinine and beneficially shifts gut microbiota.
• Variable efficacy and limitations exist for probiotics, synbiotics, and other tested interventions, with unclear causal links and methodological heterogeneity.

Conclusions:

• Gut microbiota modulation offers therapeutic potential for CKD, but clinical translation requires rigorous trials to address inconsistencies and establish mechanistic links.
• Future research should focus on longitudinal studies, maternal gut microbiota optimization, and personalized approaches for precision-based CKD prevention and management.