Targeting the Gut Microbiota in Kidney Disease: The Future in Renal Nutrition and Metabolism

Abstract

There is increasing interest in the therapeutic potential of manipulating the gut microbiome of patients with chronic kidney disease (CKD). This is because there is a substantial deviation from a balanced gut microbiota profile in CKD, with many deleterious downstream effects. Nutritional interventions such as plant-based diets with reduced animal protein intake and the use of probiotics, prebiotics, and synbiotics may alter the microbiome. This article aims to briefly describe what is known about the gut microbiome in patients with CKD, factors contributing to gut dysbiosis, and outline important evidence gaps. Future potential therapies, including restoring the microbiota with food and microbiota-based and metabolomic-based therapies, are also discussed.

Keywords: Gut microbiome; chronic kidney disease; diet; end-stage kidney disease; gastrointestinal; gut microbiota; kidney failure; nutrition; prebiotics; probiotics; synbiotics.

Figure 1.

Heat map showing some identified differences in the bacterial profile in people with chronic kidney disease compared to healthy controls.

Figure 2.

Simplified illustration of the relationship between the gut microbiome and the kidney in chronic kidney disease.