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Review
. 2018 Apr 13;10(4):155.
doi: 10.3390/toxins10040155.

The Role of Gut Microbiota and Diet on Uremic Retention Solutes Production in the Context of Chronic Kidney Disease

Laetitia Koppe  1   2 , Denis Fouque  3   4 , Christophe O Soulage  5
Affiliations
Review

The Role of Gut Microbiota and Diet on Uremic Retention Solutes Production in the Context of Chronic Kidney Disease

Laetitia Koppe et al. Toxins (Basel). .

Abstract

Uremic retention solutes (URS) are associated with cardiovascular complications and poor survival in chronic kidney disease. The better understanding of the origin of a certain number of these toxins enabled the development of new strategies to reduce their production. URS can be classified according to their origins (i.e., host, microbial, or exogenous). The discovery of the fundamental role that the intestinal microbiota plays in the production of many URS has reinstated nutrition at the heart of therapeutics to prevent the accumulation of URS and their deleterious effects. The intestinal microbiota is personalized and is strongly influenced by dietary habits, such as the quantity and the quality of dietary protein and fibers. Herein, this review out lines the role of intestinal microbiota on URS production and the recent discoveries on the effect of diet composition on the microbial balance in the host with a focus on the effect on URS production.

Keywords: chronic kidney disease; intestinal microbiota; low protein diet; nutrient composition; pro/prebiotics; uremic toxins; vegetarian diet.

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Conflict of interest statement

L.K. and C.O.S. have no conflicts of interest to disclose. D.F. has received honoraria and travel support from Fresenius Kabi which markets a ketoanalogue supplement.

Figures

Figure 1
Figure 1
Major pathways involved in the production of uremic retention solutes from nutrients and the interplay with intestinal microbiota. Abbreviation: TMAO: trimethylamine N-oxide; PST: phenolsulfotransferase; BHMT: betaine-homocysteine methyl transferase.
See this image and copyright information in PMC

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