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Role of the Gut Microbiome in Uremia: A Potential Therapeutic Target
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Also known as the "second human genome," the gut microbiome plays important roles in both the maintenance of health and the pathogenesis of disease. The symbiotic relationship between host and microbiome is disturbed due to the proliferation of dysbiotic bacteria in patients with chronic kidney disease (CKD). Fermentation of protein and amino acids by gut bacteria generates excess amounts of potentially toxic compounds such as ammonia, amines, thiols, phenols, and indoles, but the generation of short-chain fatty acids is reduced. Impaired intestinal barrier function in patients with CKD permits translocation of gut-derived uremic toxins into the systemic circulation, contributing to the progression of CKD, cardiovascular disease, insulin resistance, and protein-energy wasting. The field of microbiome research is still nascent, but is evolving rapidly. Establishing symbiosis to treat uremic syndrome is a novel concept, but if proved effective, it will have a significant impact on the management of patients with CKD.
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“Emerging evidence has led to expansion of this concept to that of the brain-gut-kidney axis9,118,160,161 (TABLE 2).”
From The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease (2018) · cites this paper as [160]
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Metadata
- Authors
- Ramezani, A., Massy, Z. A., Meijers, B., Evenepoel, P., Vanholder, R., & Raj, D. S.
- Affiliations
- George Washington University (US)
- Inserm (FR)
- Universitair Ziekenhuis Leuven (BE)
- Ghent University Hospital (BE)
- Corresponding author
- Raj, Dominic S.
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 67
- Issue
- 3
- Pages
- 483-498
- ISSN
- 0272-6386 (ISSN-L)
- PMC
- PMC5408507
- OpenAlex
- W2180350916
- Cited by
- 394
- References
- 165
- Citations by year
- 2026: 27 · 2025: 39 · 2024: 46 · 2023: 37 · 2022: 45 · 2021: 41 · 2020: 45 · 2019: 45 · 2018: 30 · 2017: 29 · 2016: 8
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- Funders
- National Institutes of Health (1R01DK073665-01A1, 1U01DK099924-01, 1U01DK099914-01)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- gut microbiota, uremia, chronic kidney disease, uremic toxins, dysbiosis, intestinal barrier dysfunction, short-chain fatty acids, protein fermentation, microbial translocation, cardiovascular disease, insulin resistance, protein-energy wasting, microbiota-based therapy
- MeSH terms
- Gastrointestinal Microbiome, Humans, Uremia, Disease Progression, Renal Insufficiency, Chronic, Early Medical Intervention, Dysbiosis
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