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Review
. 2023 Aug 17;15(16):3609.
doi: 10.3390/nu15163609.

Exploring a Complex Interplay: Kidney-Gut Axis in Pediatric Chronic Kidney Disease

Adriana Mocanu  1   2 , Roxana Alexandra Bogos  1 , Tudor Ilie Lazaruc  1 , Laura Mihaela Trandafir  1 , Vasile Valeriu Lupu  1 , Ileana Ioniuc  1 , Mirabela Alecsa  1 , Anca Ivanov  1 , Ancuta Lupu  1 , Iuliana Magdalena Starcea  1   2
Affiliations
Review

Exploring a Complex Interplay: Kidney-Gut Axis in Pediatric Chronic Kidney Disease

Adriana Mocanu et al. Nutrients. .

Abstract

The human intestinal microbiota is a highly intricate structure with a crucial role in promoting health and preventing disease. It consists of diverse microbial communities that inhabit the gut and contribute to essential functions such as food digestion, nutrient synthesis, and immune system development. The composition and function of the gut microbiota are influenced by a variety of factors, including diet, host genetics, and environmental features. In pediatric patients, the gut microbiota is particularly dynamic and vulnerable to disruption from endogenous and exogenous factors. Recent research has focused on understanding the interaction between the gut and kidneys. In individuals with chronic kidney disease, there is often a significant disturbance in the gut microbiota. This imbalance can be attributed to factors like increased levels of harmful toxins from the gut entering the bloodstream, inflammation, and oxidative stress. This review looks at what is known about the link between a child's gut-kidney axis, how dysbiosis, or an imbalance in the microbiome, affects chronic kidney disease, and what treatments, both pharmaceutical and non-pharmaceutical, are available for this condition.

Keywords: children; chronic kidney disease; gut–kidney axis; microbiota.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Relationship between dysbiosis and hypertension, mediated through NO imbalances.
Figure 2
Figure 2
Common pathogenic processes in dysbiosis and CKD. LPS—lipopolysaccharides.
Figure 3
Figure 3
Uremic toxins generated by selected bacteria in the context of dysbiosis. TMAO.
Figure 4
Figure 4
Dysbiosis promotes periurethral contamination with selected microorganisms involved in development of recurrent UTIs.
Figure 5
Figure 5
Microbiota modulatory therapies in CKD patients.
See this image and copyright information in PMC

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