Nutritional Modulation of the Gut-Kidney Axis

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.