Gut–kidney crosstalk in septic acute kidney injury

Zhang, Jingxiao; Ankawi, Ghada; Sun, Jian; Digvijay, Kumar; Yin, Yongjie; Rosner, Mitchell H.; Ronco, Claudio

doi:10.1186/s13054-018-2040-y

Cited by 95Acute Kidney Injury ResearchSepsis Diagnosis and TreatmentChemotherapy-induced organ toxicity mitigation

Gut–kidney crosstalk in septic acute kidney injury

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Zhang, Jingxiao, Ankawi, Ghada, Sun, Jian, Digvijay, Kumar, Yin, Yongjie, Rosner, Mitchell H., Ronco, Claudio·2018·Critical Care

DOI 10.1186/s13054-018-2040-yPMC PMC5934860

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Abstract

Sepsis is the leading cause of acute kidney injury (AKI) in the intensive care unit (ICU). Septic AKI is a complex and multifactorial process that is incompletely understood. During sepsis, the disruption of the mucus membrane barrier, a shift in intestinal microbial flora, and microbial translocation may lead to systemic inflammation, which further alters host immune and metabolic homeostasis. This altered homeostasis may promote and potentiate the development of AKI. As part of this vicious cycle, when AKI develops, the clearance of inflammatory mediators and metabolic products is decreased. This will lead to further gut injury and breakdown in mucous membrane barriers. Thus, changes in the gut during sepsis can initiate and propagate septic AKI. This deleterious gut-kidney crosstalk may be a potential target for therapeutic maneuvers. This review analyses the underlying mechanisms in gut-kidney crosstalk in septic AKI.

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Gut-derived inflammatory mediators and endotoxins entering the bloodstream may exacerbate renal injury.
“Gut-derived inflammatory mediators and endotoxins that enter the bloodstream may exacerbate renal injury [31,32].”
From Gastrointestinal function and nutritional interventions in septic shock (2025) · cites this paper as [32]
The Background (page unavailable) says gut-derived bacteria and toxins may enter systemic circulation, amplify inflammation, and potentiate acute kidney injury. The paper also mentions intestinal endotoxin production, but does not specifically say that gut-derived inflammatory mediators enter the bloodstream; it describes systemic inflammation arising after gut-barrier disruption. (LLM, conf=0.78)
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Aerosol inhalation of a hydrogen-rich solution restored septic renal function
Yao, W., Guo, A., Han, X., Wu, S., Chen, C., Luo, C., Li, H., Li, S., & Hei, Z. (2019) · Aging · doi:10.18632/aging.102542 · Cited by 40 · see citing works
Norepinephrine Contributes to Enterocyte Damage in Septic Shock Patients: A Prospective Cohort Study
Habes, Q. L. M., van Ede, L., Gerretsen, J., Kox, M., & Pickkers, P. (2017) · Shock · doi:10.1097/shk.0000000000000955 · Cited by 32 · cited 1× · see citing works
“In septic patients, inflammation and hypoperfusion play an important role in the pathophysiology of gut injury [11].”
Background
Propionate induces the release of granules from bovine neutrophils
Carretta, M. D., Conejeros, I., Hidalgo, M. A., & Burgos, R. A. (2013) · Journal of Dairy Science · doi:10.3168/jds.2012-6111 · Cited by 29 · cited 1× · see citing works
“SCFAs can directly affect Treg cells [52, 53], neutrophils [54], monocytes [55], and mast cell [56] through the GPRs expressed on them, which will modulate the immune homeostasis of the body.”
Background
n-Butyrate inhibits Jun NH(2)-terminal kinase activation and cytokine transcription in mast cells
Diakos, C., Prieschl, E. E., Säemann, M. D., Böhmig, G. A., Csonga, R., Sobanov, Y., Baumruker, T., & Zlabinger, G. J. (2006) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2006.08.117 · Cited by 29 · cited 1× · see citing works
“SCFAs can directly affect Treg cells [52, 53], neutrophils [54], monocytes [55], and mast cell [56] through the GPRs expressed on them, which will modulate the immune homeostasis of the body.”
Background
Change of surfactant protein D and A after renal ischemia reperfusion injury
Imtiazul, I. M., Asma, R., Lee, J., Cho, N., Park, S., Song, H., & Gil, H. (2019) · PLoS ONE · doi:10.1371/journal.pone.0227097 · Cited by 11 · see citing works

Flagged first, then by citations

Sorted by citations

Gut–organ axis: a microbial outreach and networking
Ahlawat, S., Asha, A., & Sharma, K. K. (2020) · Letters in Applied Microbiology · doi:10.1111/lam.13333 · Cited by 363 · see citing works
“Improved kidney function in septic AKI was observed when microbialderived SCFAs therapy was administered.”
BackgroundInfluential
Sepsis and Acute Kidney Injury: A Review Focusing on the Bidirectional Interplay
Chang, Y., Chou, Y., Kan, W., & Shiao, C. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23169159 · Cited by 128 · see citing works
Pathophysiological Mechanisms by which Heat Stress Potentially Induces Kidney Inflammation and Chronic Kidney Disease in Sugarcane Workers
Hansson, E., Glaser, J. R., Jakobsson, K., Weiss, I., Wesseling, C., Lucas, R. A. I., LEE, J. K. W., Ekström, U., Wijkström, J., Bodin, T., et al. (2020) · Nutrients · doi:10.3390/nu12061639 · Cited by 129 · see citing works
The central and biodynamic role of gut microbiota in critically ill patients
Wozniak, H., Beckmann, T. S., Fröhlich, L., Soccorsi, T., Terrier, C. L., de Watteville, A., Schrenzel, J., & Heidegger, C. (2022) · Critical Care · doi:10.1186/s13054-022-04127-5 · Cited by 100 · see citing works
“This increases inflammation and promotes the switch to renal aerobic glycolysis, leading to a decrease in ATP stores and ultimately to mitochondrial and cellular damage in the kidney [157].”
Background
Acute kidney injury and distant organ dysfunction–network system analysis
Matsuura, R., Doi, K., & Rabb, H. (2023) · Kidney International · doi:10.1016/j.kint.2023.03.025 · Cited by 100 · see citing works
UCP2 ameliorates mitochondrial dysfunction, inflammation, and oxidative stress in lipopolysaccharide-induced acute kidney injury
Ding, Y., Zheng, Y., Huang, J., Peng, W., Chen, X., Kang, X., & Zeng, Q. (2019) · International Immunopharmacology · doi:10.1016/j.intimp.2019.03.043 · Cited by 82 · see citing works
Large animal models for translational research in acute kidney injury
Packialakshmi, B., Stewart, I. J., Burmeister, D. M., Chung, K. K., & Zhou, X. (2020) · Renal Failure · doi:10.1080/0886022x.2020.1830108 · Cited by 54 · see citing works
Csf2 Attenuated Sepsis-Induced Acute Kidney Injury by Promoting Alternative Macrophage Transition
Li, Y., Zhai, P., Zheng, Y., Zhang, J., Kellum, J. A., & Peng, Z. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.01415 · Cited by 53 · see citing works
Self-citation
Organ cross-talk: molecular mechanisms, biological functions, and therapeutic interventions for diseases
Che, H., Gao, Y., Xu, Y., Xu, H., Eils, R., & Tian, M. (2026) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-025-02329-1 · Cited by 55 · see citing works
“309 This bidirectional cross-talk, pivotal for ﬂ uid balance, immune regulation, and metabolic harmony, falters in renal diseases, highlighting the role of the gut as a sentinel of kidney health and systemic in ﬂ ammation (Fig.”
Microbiome-Metabolome Signature of Acute Kidney Injury
Andrianova, N. V., Popkov, V. A., Klimenko, N. S., Tyakht, A., Baydakova, G., Frolova, O. Y., Zorova, L. D., Pevzner, I. B., Zorov, D. B., & Plotnikov, E. Y. (2020) · Metabolites · doi:10.3390/metabo10040142 · Cited by 50 · see citing works
Organ Crosstalk in Acute Kidney Injury: Evidence and Mechanisms
Li, X., Yuan, F., & Zhou, L. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11226637 · Cited by 49 · see citing works
MiR-590-3p Attenuates Acute Kidney Injury by Inhibiting Tumor Necrosis Factor Receptor-Associated Factor 6 in Septic Mice
Ma, J., Li, Y., Zhang, S.-X., Fu, S., & Ye, X.-Z. (2018) · Inflammation · doi:10.1007/s10753-018-0921-5 · Cited by 45 · see citing works
Integrated Fecal Microbiome and Serum Metabolomics Analysis Reveals Abnormal Changes in Rats with Immunoglobulin A Nephropathy and the Intervention Effect of Zhen Wu Tang
Li, J., Cao, Y., Lu, R., Li, H., Pang, Y., Fu, H., Fang, G., Chen, Q., Liu, B., Wu, J., et al. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.606689 · Cited by 42 · see citing works
Aerosol inhalation of a hydrogen-rich solution restored septic renal function
Yao, W., Guo, A., Han, X., Wu, S., Chen, C., Luo, C., Li, H., Li, S., & Hei, Z. (2019) · Aging · doi:10.18632/aging.102542 · Cited by 40 · see citing works
“An excessive inflammatory response and oxidative stress are considered to be the main mechanisms of septic AKI [9, 10].”
Background
Global Proteome and Phosphoproteome Characterization of Sepsis-induced Kidney Injury
Lin, Y.-H., Platt, M. P., Fu, H., Gui, Y., Wang, Y., González-Juarbe, N., Zhou, D. F., & Yu, Y. (2020) · Molecular & Cellular Proteomics · doi:10.1074/mcp.ra120.002235 · Cited by 36 · see citing works
Acute Kidney Injury and Gut Dysbiosis: A Narrative Review Focus on Pathophysiology and Treatment
Chou, Y., Kan, W., & Shiao, C. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23073658 · Cited by 34 · see citing works
“The inadequate clearance of water and metabolic waste (especially urea) from AKI is one culprit to intestinal dysbiosis [26].”
Background
Significance of the Gut Microbiota in Acute Kidney Injury
Kobayashi, T., Iwata, Y., Nakade, Y., & Wada, T. (2021) · Toxins · doi:10.3390/toxins13060369 · Cited by 32 · see citing works
HMGB1 signaling-regulated endoplasmic reticulum stress mediates intestinal ischemia/reperfusion-induced acute renal damage
Lai, H.-J., Zhan, Y., Qiu, Y., Ling, Y., Zhang, X., Chang, Z., Zhang, Y., Liu, Z., & Wen, S. (2021) · Surgery · doi:10.1016/j.surg.2021.01.042 · Cited by 32 · see citing works
Ferroptosis: a potential bridge linking gut microbiota and chronic kidney disease
Mao, Z., Gao, Z., Pan, S.-K., Liu, D., Liu, Z., & Wu, P. (2024) · Cell Death Discovery · doi:10.1038/s41420-024-02000-8 · Cited by 30 · see citing works
“Disruption of the intestinal mucosal barrier, alterations in the microbiota, and microbial translocation lead to systemic in ﬂ ammation, further impacting the host ’ s immune and metabolic homeostasis [4].”
Background
Gut microbiota in surgical and critically ill patients
Ho, K. M., Kalgudi, S., Corbett, J.-M., & Litton, E. (2020) · Anaesthesia and Intensive Care · doi:10.1177/0310057x20903732 · Cited by 32 · see citing works
Intestinal microbiota dysbiosis in acute kidney injury: novel insights into mechanisms and promising therapeutic strategies
Lei, J., Xie, Y., Sheng, J., & Song, J. (2022) · Renal Failure · doi:10.1080/0886022x.2022.2056054 · Cited by 31 · see citing works
“During AKI sepsis, the disruption of the mucus membrane barrier may worsen systemic inflammation and potentiation of AKI [50].”
Background
Distal organ inflammation and injury after resuscitative endovascular balloon occlusion of the aorta in a porcine model of severe hemorrhagic shock
Li, Y., Dubick, M. A., Yang, Z., Barr, J. L., Gremmer, B. J., Lucas, M. L., Necsoiu, C. N., Jordan, B. S., Batchinsky, A. I., & Cancio, L. C. (2020) · PLoS ONE · doi:10.1371/journal.pone.0242450 · Cited by 25 · see citing works
“Although liver tissue is relatively resistant to IRI itself, this condition triggers the generation of many factors including cytokines and chemokines produced by Kupffer cells (KCs), anaerobic metabolism, mitochondrial damage, oxidative stress, and intracellular Ca2+ overload, which cause acute liver failure (ALF) as…”
Background
MicroRNAs in septic acute kidney injury
Wang, B., Xu, J., Fu, P., & Ma, L. (2023) · Burns & Trauma · doi:10.1093/burnst/tkad008 · Cited by 25 · see citing works
“Inflammation and oxidative stress are considered to be the main pathogenesis of septic AKI [82].”
Background
Gut-derived 4-hydroxyphenylacetic acid attenuates sepsis-induced acute kidney injury by upregulating ARC to inhibit necroptosis
An, S. L., Yao, Y., Wu, J., Hu, H., Wu, J., Sun, M., Li, J., Zhang, Y., Li, L., Qiu, W., et al. (2023) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2023.166876 · Cited by 24 · see citing works
Role of the Gut Microbiota in Children with Kidney Disease
Tain, Y., & Hsu, C. (2023) · Children · doi:10.3390/children10020269 · Cited by 24 · see citing works
Total alkaloids of Aconitum carmichaelii Debx alleviate cisplatin-induced acute renal injury by inhibiting inflammation and oxidative stress related to gut microbiota metabolism
Yang, X., Xin, Y., Gu, Y., Wang, Y., Hu, X., Ying, G., Zhang, Q., & He, X. (2024) · Phytomedicine · doi:10.1016/j.phymed.2024.156128 · Cited by 22 · see citing works
Intestinal Injury Biomarkers Predict Mortality in Pediatric Severe Malaria
Sarangam, M. L., Namazzi, R., Datta, D., Bond, C., Vanderpool, C. P. B., Opoka, R. O., John, C. C., & Conroy, A. L. (2022) · mBio · doi:10.1128/mbio.01325-22 · Cited by 22 · see citing works
“translocation of enteric microbial products in intestinal injury may promote AKI (29).”
Background
Polymyxin B-Associated Nephrotoxicity and Its Predictors: A Retrospective Study in Carbapenem-Resistant Gram-Negative Bacterial Infections
Wu, X., Long, W.-M., Lu, Q., Teng, X.-Q., Qi, T.-T., Qu, Q., He, G., & Qu, J. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.672543 · Cited by 21 · see citing works
Progress in the study of the correlation between sepsis and intestinal microecology
Tao, Y.-L., Wang, J.-R., Liu, M., Liu, Y., Zhang, J., Zhou, Y., Li, S., & Zhu, S.-F. (2024) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2024.1357178 · Cited by 21 · see citing works
Self-citation
Hydrogen: A Novel Treatment Strategy in Kidney Disease
Wang, B., Li, Z., Mao, L., Zhao, M., Yang, B.-C., Tao, X., Yu-xiang, L., & Yin, G. (2022) · Kidney Diseases · doi:10.1159/000520981 · Cited by 21 · see citing works
Protein modification by short-chain fatty acid metabolites in sepsis: a comprehensive review
Zhang, L., Shi, X., Qiu, H., Liu, S., Yang, T., Li, X., & Liu, X. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1171834 · Cited by 22 · see citing works
Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
Vega, M. W., Cerminara, D. N., Desloovere, A., Paglialonga, F., Renken‐Terhaerdt, J., Walle, J. V., Shaw, V., Stabouli, S., Anderson, C. E., Haffner, D., et al. (2023) · Pediatric Nephrology · doi:10.1007/s00467-023-05884-3 · Cited by 17 · see citing works
Probiotics in septic acute kidney injury, a double blind, randomized control trial
Chavez-Iñiguez, J. S., Ibarra-Estrada, M. Á., Gallardo-González, A. M., Cisneros-Hernández, A., Granado, R. C., Chávez-Alonso, G., Hernández-Barajas, E. M., Romero-Muñoz, A. C., Avellaneda, F. R., Prieto-Magallanes, M. L., et al. (2023) · Renal Failure · doi:10.1080/0886022x.2023.2260003 · Cited by 18 · see citing works
“This effect could be explained by the modulation of intestinal dysbiosis with pro-biotics and thus the attenuation of urea generation by intestinal bacteria [8], especially in the context of AKI associated with sepsis [48].”
Background
Gut Microbiota Metabolites Targeting the Immune Response in Sepsis: Mechanisms and Therapies
Xu, P. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s539237 · Cited by 18 · see citing works
CHIP protects against septic acute kidney injury by inhibiting NLRP3-mediated pyroptosis
Zhang, H., Deng, Z., Wang, Y., Zheng, X., Zhou, L., Shu, Y., Wang, Y., Dai, Y., Kanwar, Y. S., & Deng, F. (2023) · iScience · doi:10.1016/j.isci.2023.107762 · Cited by 16 · see citing works
Investigating gut microbiota–blood and urine metabolite correlations in early sepsis-induced acute kidney injury: insights from targeted KEGG analyses
Xu, Y., Xu, J., Zhu, Y., Mao, H., Li, J., Kong, X., Zhu, X., & Zhang, J. (2024) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2024.1375874 · Cited by 16 · see citing works
“Existing research suggests that the gut microbiota is involved in the occurrence and progression of SA-AKI (Zhang et al., 2018; Cha ́ vez-Iñiguez et al., 2022; Xu et al., 2022).”
Self-citation
LncRNA TCONS_00145741 Knockdown Prevents Thrombin-Induced M1 Differentiation of Microglia in Intracerebral Hemorrhage by Enhancing the Interaction Between DUSP6 and JNK
Wu, L., Zhan, Q., Liu, P., Zheng, H., Liu, M., Min, J., Xie, L., & Wu, W. (2022) · Frontiers in Cell and Developmental Biology · doi:10.3389/fcell.2021.684842 · Cited by 15 · see citing works
Kidney-gut crosstalk in renal disease
Colombo, I., Aiello, F. I., Elena, R., Ruiz, A., Petraglia, L., & Musso, C. G. (2020) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-020-02437-7 · Cited by 15 · see citing works
“Some of these lost bacteria have the beneficial role of catabolizing polysaccharides to generate short-chain fatty acids with the mentioned effect in immunomodulation [24].”
BackgroundInfluential
Increasing incidence of acute kidney injury in pediatric severe sepsis and related adverse hospital outcomes
Khatana, J., Thavamani, A., Umapathi, K. K., Sankararaman, S., & Roy, A. (2023) · Pediatric Nephrology · doi:10.1007/s00467-022-05866-x · Cited by 14 · see citing works
Pellino1 orchestrates gut-kidney axis to perpetuate septic acute kidney injury through activation of STING pathway and NLRP3 inflammasome
Yu, J., Zhu, G., Qiu, C., Lai, J.-M., Shen, Y., Jin, S., Yang, X., Zhu, H., Hu, B., Ye, X., et al. (2024) · Life Sciences · doi:10.1016/j.lfs.2024.122604 · Cited by 14 · see citing works
Gastrointestinal function and nutritional interventions in septic shock
Bachmann, K. F., Cotoia, A., & Reintam Blaser, A. (2025) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000001302 · Cited by 13 · see citing works
“GI-renal: Gut-derived inflammatory endotoxins that enter the bloodstream may exacerbate renal injury [31,32].”
Clinical utility of characterizing intestinal flora in septic kidney injury
Yuan, J., Chang, X., Li, M., Yuan, Q.-X., & Yang, X. (2020) · Chinese Medical Journal · doi:10.1097/cm9.0000000000000724 · Cited by 11 · see citing works
Change of surfactant protein D and A after renal ischemia reperfusion injury
Imtiazul, I. M., Asma, R., Lee, J., Cho, N., Park, S., Song, H., & Gil, H. (2019) · PLoS ONE · doi:10.1371/journal.pone.0227097 · Cited by 11 · see citing works
“SP-A and SP-D play important roles in innate immunity and in the modulation of inflammation in pulmonary infections [6, 7].”
Sepsis and the diverse organ-gastrointestinal tract axis
Wang, J. D. J., Suan, E., Li, S. S., & Shelat, V. G. (2025) · World Journal of Critical Care Medicine · doi:10.5492/wjccm.v14.i4.105547 · Cited by 12 · see citing works
Kidney–Gut Crosstalk in AKI
Jo, S. (2021) · Kidney360 · doi:10.34067/kid.0007722020 · Cited by 10 · see citing works
“have also suggested the gut as an amplifier of systemic inflammation in septic AKI (13).”
Background
Serum total protein-to-albumin ratio predicts risk of death in septic acute kidney injury patients: A cohort study
Yin, T., Wei, W., Huang, X., Liu, C., Li, J., Cheng, Y., Yang, L., Ma, L., Zhang, L., Zhao, Y., et al. (2023) · International Immunopharmacology · doi:10.1016/j.intimp.2023.111358 · Cited by 9 · see citing works
Metabolomic interplay between gut microbiome and plasma metabolome in cardiac surgery‐associated acute kidney injury
Bai, Y., Huang, W., Jiang, X., Wang, X., Li, Y., Wang, Y., Huang, S., Wu, K., Hu, L., & Chen, C. (2023) · Rapid Communications in Mass Spectrometry · doi:10.1002/rcm.9504 · Cited by 9 · see citing works
Genetic Deletion of LRP5 and LRP6 in Macrophages Exacerbates Colitis-Associated Systemic Inflammation and Kidney Injury in Response to Intestinal Commensal Microbiota
Manoharan, I., Swafford, D., Shanmugam, A., Patel, N., Prasad, P. D., Mohamed, R., Wei, Q., Dong, Z., Thangaraju, M., & Manicassamy, S. (2022) · The Journal of Immunology · doi:10.4049/jimmunol.2101172 · Cited by 9 · see citing works
Acute Kidney Injury and Intestinal Dysbiosis
Chavez-Iñiguez, J. S., Gutierrez, L. Y. V., & Gallardo-González, A. M. (2022) · Frontiers in Nephrology · doi:10.3389/fneph.2022.916151 · Cited by 9 · see citing works
“There are also reports on bacterial translocation (elevated during AKI) as a consequence of uremia (22).”
Background
EFFECTS OF HYPERBARIC OXYGEN THERAPY ON INTESTINAL ISCHEMIA-REPERFUSION AND ITS MECHANISM
Song, S., Li, R., Wu, C., Dong, J., & Wang, P. (2023) · Shock · doi:10.1097/shk.0000000000002287 · Cited by 8 · see citing works
Nutrition for critically ill children and neonates requiring dialysis: Application of clinical practice recommendations
Vega, M. W., Vuong, K. T., Chmielewski, J., Gollins, L. A., Slagle, C. L., Srivaths, P. R., & Akcan‐Arikan, A. (2023) · Nutrition in Clinical Practice · doi:10.1002/ncp.11048 · Cited by 8 · see citing works
Factors associated with gastrointestinal dysmotility in critically ill patients
Petrović, N. Z., Žunić, M., Pejčić, A. V., Milosavljević, M. N., & Јаnkovic, S. (2023) · Open Medicine · doi:10.1515/med-2023-0820 · Cited by 8 · see citing works
“…for the development of constipation in these patients are accumulation of in ﬂ ammatory mediators and degradational products of metabolism in the GIT [29] and modi ﬁ cation of the intestinal ﬂ ora (dysbiosis) due to inadequate water intake and secretion of urea from the intestinal wall [30].”
Background
Interplay between gut microbiota and acute kidney injury: a review of their mutual influence and causation
Mali, N., Mali, S., Zhang, L., & Fu, P. (2025) · Renal Failure · doi:10.1080/0886022x.2025.2522976 · Cited by 7 · see citing works
“Additionally, the use of parenteral nutrition and decreasing gut microbiota abundance lead to decreased synthesis of SCFAs, which have immune-modulating qualities [78].”
Structural-activity relationship of Lycium barbarum polysaccharides in immunomodulation: integrating molecular insights with target identification for therapeutic development
Wang, B., Yang, J., Tao, L., Zhou, X., & Ding, X. (2026) · Frontiers in Immunology · doi:10.3389/fimmu.2026.1730418 · Cited by 7 · see citing works
“Research indicates that GPR43 has a greater af ﬁ nity for acetate and propionate, while GPR41 displays higher sensitivity to propionate and butyrate (135, 136).”
Microbe defines the efficacy of chemotherapeutic drug: a complete paradigm
Dalal, P., & Sharma, D. (2021) · FEMS Microbiology Letters · doi:10.1093/femsle/fnab116 · Cited by 6 · see citing works
Dextran sodium sulfate‐induced colitis in male BALB /c mice leads to albuminuria and increased markers of inflammation and tissue damage in the kidney
Salmenkari, H., Adeshara, K. A., Pirttiniemi, A., Lindén, J., Lehtonen, S. H., Sandholm, N., Groop, P., & Lehto, M. J. (2025) · Physiological Reports · doi:10.14814/phy2.70161 · Cited by 5 · see citing works
“Acute kidney injury is a serious complication of sepsis, but it is not directly comparable to the etiology of kidney complications in human IBD or diabetes (Kumar et al., 2022; Zhang et al., 2018).”
The Clinical View of Sepsis-Associated AKI: How Basic Science Can Help Solve This Problem
Odum, J. D., Hasson, D. C., Stanski, N. L., Gómez, H., & Soranno, D. E. (2025) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2025.151665 · Cited by 5 · see citing works
Novel MAGL Inhibitors Alleviate LPS-Induced Acute Kidney Injury by Inhibiting NLRP3 Inflammatory Vesicles, Modulating Intestinal Flora, Repairing the Intestinal Barrier, and Interfering with Serum Metabolism
Xiang, H., Wang, Y., Yang, L., Liu, M., Sun, C., Gu, Y., & Yao, J. (2023) · Molecules · doi:10.3390/molecules28217245 · Cited by 5 · see citing works
“Impaired intestinal barrier integrity will increase the potential for intestinal contents to enter the bloodstream through the intestinal epithelium, exacerbating intestinal dysbiosis and leading to the entry of dysbiotic microbial metabolites into the bloodstream, exacerbating kidney injury [8].”
Background
Septic acute kidney injury and gut microbiome: Should we change our approach?
Dicu-Andreescu, I., Penescu, M. N., & Verzan, C. (2024) · Nefrología (English Edition) · doi:10.1016/j.nefroe.2024.03.024 · Cited by 5 · see citing works
Positive pathogens in stool could predict the clinical outcomes of sepsis-associated acute kidney injury in critical ill patient
Cao, Y., & Deng, F. (2024) · Scientific Reports · doi:10.1038/s41598-024-62136-6 · Cited by 5 · see citing works
Targeting the gut-kidney axis to improve kidney transplantation prognosis: from mechanisms to clinical intervention strategies
Cao, H., Sun, J., Lv, Y., Ye, J., Wang, Y., & Jiang, H. (2026) · Renal Failure · doi:10.1080/0886022x.2026.2642487 · Cited by 4 · see citing works
“…reports indicate that in septic aKi, elevated levels of inflammatory cytokines such as iL-6, tnf-α, and iL-1β lead to intestinal wall ischemia, edema, and increased permeability. this further amplifies the systemic inflammatory response, resulting in various organ dysfunctions and even death [32].”
Self-citation
Investigations of Enteric-Coated Tablet Propyl Gallate-Induced Nephrotoxicity in Beagles as well as Human and Dog Renal Proximal Tubule Epithelial Cells
Mou, S., Hummer, B. T., Yuan, J., Huang, Y., Liang, M., Faggioni, R., Roskos, L. K., & Rosenbaum, A. I. (2025) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.4c00563 · Cited by 4 · see citing works
Septic acute kidney injury and gut microbiome: Should we change our approach?
Dicu-Andreescu, I., Penescu, M. N., & Verzan, C. (2023) · Nefrología · doi:10.1016/j.nefro.2023.05.011 · Cited by 4 · see citing works
“41,43 Interestingly, macrophages started to polarize to M2 anti-inﬂammatory, which also facilitates tissue repair, both in the gut and the kidney after antibiotics.”
BackgroundInfluential
Activated Carbon for Sepsis Prevention and Intervention: A Modern Way of Utilizing Old Therapies
Snezhkova, E. A., Redl, H. R., Grillari, J., & Osuchowski, M. F. (2023) · C – Journal of Carbon Research · doi:10.3390/c9030072 · Cited by 4 · see citing works
Evaluation of the Efficiency of TIMP-2 as a Biomarker for Acute Kidney Injury in Sepsis
Li, S., Ren, S., Long, L., Zhao, H., & Shen, L. (2023) · Bulletin of Experimental Biology and Medicine · doi:10.1007/s10517-023-05791-5 · Cited by 4 · see citing works
“AKI-related pathological studies showed that plasma TIMP-2 is mainly expressed and secreted by distal tubule cells [6,7].”
Background
Nutrition in Critically Ill Children with AKI on Continuous RRT: Consensus Recommendations
Raina, R., Suchan, A., Sethi, S. K., Soundararajan, A., Vitale, V. S., Keller, G. L., Brown, A., Davenport, A., Shih, W. V., Nada, A., et al. (2023) · Kidney360 · doi:10.34067/kid.0000000000000339 · Cited by 3 · see citing works
Constipation in critically ill adults
Kim, Y., & See, K. C. (2025) · World Journal of Gastrointestinal Pathophysiology · doi:10.4291/wjgp.v16.i4.112019 · Cited by 4 · see citing works
“Acute kidney injury, for example, has been associated with an increased risk of constipation, potentially due to the accumulation of inflammatory mediators and metabolic waste products within the gastrointestinal tract[24,31].”
Indole-3-carboxaldehyde from Limosilactobacillus reuteri targets the DUSP1/ERK/NOX2/ROS axis to enhance the bactericidal activity of macrophages and protects against sepsis
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Self-citation
Surgical Sepsis and Organ Crosstalk: The Role of the Kidney
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Authors: Zhang, J., Ankawi, G., Sun, J., Digvijay, K., Yin, Y., Rosner, M. H., & Ronco, C.
Affiliations: Jilin University (CN)
King Abdulaziz University (SA)
Sir Ganga Ram Hospital (IN)
University of Virginia Health System (US)
Ospedale San Bortolo (IT)
Corresponding author: Yin, Yongjie
ORCID: Zhang, Jingxiao
Ankawi, Ghada
Sun, Jian
Digvijay, Kumar
Yin, Yongjie
Rosner, Mitchell H.
Ronco, Claudio
Venue: Critical Care
Publisher: Springer Science and Business Media LLC
Published: 2018-05-03
Volume: 22
Issue: 1
Pages: 117-117
ISSN: 1364-8535 (ISSN-L)
DOI: 10.1186/s13054-018-2040-y
PMC: PMC5934860
OpenAlex: W2806389041
Cited by: 95
References: 63
Citations by year: 2026: 16 · 2025: 13 · 2024: 10 · 2023: 21 · 2022: 14 · 2021: 7 · 2020: 10 · 2019: 3 · 2018: 1
FWCI: 0.90
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (tdm)
Locations: Critical Care (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, other-oa)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics: Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Pathology and Forensic Medicine › Chemotherapy-induced organ toxicity mitigation
Keywords: sepsis-associated acute kidney injury, sepsis, intestinal barrier dysfunction, microbial translocation, gut microbiota, systemic inflammation, inflammatory mediators, metabolic homeostasis, intestinal injury
MeSH terms: Humans, Intensive Care Units, Kidney, Sepsis, Gastrointestinal Tract, Acute Kidney Injury, Microbiota

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Gut–kidney crosstalk in septic acute kidney injury

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