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Nutritional Modulation of the Gut-Kidney Axis.

Razvan George Bogdan1, Felicia Gabriela Gligor2, Paula Anderco2

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Summary

Combining nutritional interventions may improve chronic kidney disease (CKD) by targeting gut dysbiosis and inflammation. This approach addresses immune activation and metabolic endotoxemia, offering potential benefits over single-dietary strategies for kidney health.

Keywords:
bioactive peptideschronic kidney diseasegut–kidney axisimmunonutritionomega-3 fatty acidsshort-chain fatty acids

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Area of Science:

  • Immunonutrition
  • Gut-kidney axis
  • Chronic kidney disease (CKD) pathogenesis

Background:

  • CKD involves chronic inflammation, driven by innate immune activation, accelerating kidney decline and cardiovascular issues.
  • Diet-induced gut dysbiosis and impaired intestinal barrier function contribute to metabolic endotoxemia and systemic inflammation via the gut-kidney axis.

Purpose of the Study:

  • To review and integrate evidence on how microbiota metabolites, bioactive peptides, and omega-3 fatty acids converge to impact CKD progression.
  • To examine shared mechanisms including epithelial barrier integrity, immune polarization, oxidative stress, and inflammasome pathways.

Main Methods:

  • Review of existing literature on nutritional factors and their impact on CKD.
  • Analysis of convergent mechanisms of action for different dietary components.
  • Focus on key pathways: SCFA production, uremic toxins, bioactive peptides, and omega-3 fatty acids.

Main Results:

  • CKD dysbiosis reduces beneficial short-chain fatty acids (SCFAs) and increases harmful uremic toxins.
  • Reduced SCFAs impair barrier function and promote inflammatory Th17 responses.
  • Bioactive peptides and omega-3s modulate inflammation and immune responses, with shared targets like barrier integrity and NLRP3 inflammasome activation.

Conclusions:

  • Combined nutritional strategies targeting convergent pathways may be more effective than isolated interventions for CKD.
  • Further multi-omics and factorial trials are needed to personalize immunonutrition for CKD patients.