Review: Uremic Toxins and Gut Microbiome

Abstract

Recent progress of metagenomic analysis of gut microbiome reveals close interactions between the gut microbiome and host human’s diseases. In chronic kidney disease (CKD), alternations of microbiome composition which promote CKD and cardiovascular disease (CVD) progression are called “dysbiosis.” In dysbiotic gut microbiota, increasement of gut-derived protein bound uremic toxins (Indoxyl sulfate p-Cresyl sulfate, phenyl sulfate) and trimethylamine-N-oxide, reduction of short chain fatty acids production, dysregulated bile acid metabolism, and gut epithelial barrier dysfunction collectively deteriorate CKD/CVD progression to form “vicious cycle”. The methods to improve dysbiotic microbiome in CKD patients to shift the vicious cycle of gut dysbiosis–kidney–cardiovascular axis are promising therapeutic strategies to CKD.