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The role of the gastrointestinal tract and microbiota on uremic toxins and chronic kidney disease development

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Abstract

It is well-established that uremic toxins are positively correlated with the risk of developing chronic kidney disease and cardiovascular disease. In addition, emerging data suggest that gut bacteria exert an influence over both the production of uremic toxins and the development of chronic kidney disease. As such, modifying the gut microbiota may have the potential as a treatment for chronic kidney disease. This is supported by data that suggest that rescuing microbiota dysbiosis may: reduce uremic toxin production; prevent toxins and pathogens from crossing the intestinal barrier; and, reduce gastrointestinal tract transit time allowing nutrients to reach the microbiota in the distal portion of the gastrointestinal tract. Despite emerging literature, the gut–kidney axis has yet to be fully explored. A special focus should be placed on examining clinically translatable strategies that might encourage improvements to the microbiome, thereby potentially reducing the risk of the development of chronic kidney disease. This review aims to present an overview of literature linking changes to the gastrointestinal tract with microbiota dysbiosis and the development and progression of chronic kidney disease.

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Abbreviations

CKD:

Chronic kidney disease

CVD:

Cardiovascular disease

GIT:

Gastrointestinal tract

PCS:

p-Cresyl sulfate

IS:

Indoxyl sulfate

CHO:

Carbohydrate

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Authors and Affiliations

  1. School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia

    David Briskey & Jeff S. Coombes

  2. Clinical Biochemistry Laboratory, Central Queensland University, Rockhampton, Australia

    Patrick Tucker

  3. Centre for Kidney Disease Research, School of Medicine, University of Queensland at Princess Alexandra Hospital, Brisbane, Australia

    David W. Johnson

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  1. David Briskey
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Correspondence to David Briskey.

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Briskey, D., Tucker, P., Johnson, D.W. et al. The role of the gastrointestinal tract and microbiota on uremic toxins and chronic kidney disease development. Clin Exp Nephrol 21, 7–15 (2017). https://doi.org/10.1007/s10157-016-1255-y

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  • DOI: https://doi.org/10.1007/s10157-016-1255-y

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