Gut-kidney axis in chronic kidney disease: Dysbiosis, uremic metabolites and therapeutic opportunities (Review)
- 1Department of Nephrology, The Third Affiliated Hospital of Gansu University of Chinese Medicine, Baiyin, Gansu 730900, P.R. China
- 2Department of Nephrology, Baiyin Hospital of Integrated Traditional Chinese and Western Medicine, Baiyin, Gansu 730900, P.R. China
Abstract
Chronic kidney disease (CKD) poses a notable global health burden. Beyond traditional pathways, the gut-kidney axis has emerged as a potential contributor to disease progression. In the present narrative review, current evidence on the role of intestinal dysbiosis, characterized by reduced microbial diversity, depletion of beneficial short-chain fatty acid producers and expansion of uremic toxin-generating bacteria, in the accumulation of nephrotoxic metabolites (such as indoxyl sulfate, p-cresyl sulfate and trimethylamine N-oxide) is summarized. These toxins promote oxidative stress, inflammation and fibrosis, accelerating renal decline. By contrast, microbially derived short-chain fatty acids exert protective effects. Although therapeutic strategies targeting the gut microbiome (including probiotics, prebiotics and adsorbents) and fecal microbiota transplantation (targeting the gut microbiome) exhibit potential in modulating toxin levels, evidence for clinical endpoint benefit remains insufficient. In the present review, mechanistic insights were critically evaluated, clinical intervention studies are systematically summarized in tabulated form and a roadmap for personalized, microbiota-informed therapeutic strategies is proposed.
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BibTeX
@article{wang2026gutkidney,
title = {{Gut-kidney axis in chronic kidney disease: Dysbiosis, uremic metabolites and therapeutic opportunities (Review)}},
author = {Yinding Wang and Hanyu Zeng and Na Liu and Dong Yang},
journal = {Molecular Medicine Reports},
year = {2026},
month = oct,
doi = {10.3892/mmr.2026.14047},
url = {https://doi.org/10.3892/mmr.2026.14047},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Gut-kidney axis in chronic kidney disease: Dysbiosis, uremic metabolites and therapeutic opportunities (Review)
AU - Yinding Wang
AU - Hanyu Zeng
AU - Na Liu
AU - Dong Yang
PY - 2026
DA - 2026/10/16
JO - Molecular Medicine Reports
DO - 10.3892/mmr.2026.14047
UR - https://doi.org/10.3892/mmr.2026.14047
AB - Chronic kidney disease (CKD) poses a notable global health burden. Beyond traditional pathways, the gut-kidney axis has emerged as a potential contributor to disease progression. In the present narrative review, current evidence on the role of intestinal dysbiosis, characterized by reduced microbial diversity, depletion of beneficial short-chain fatty acid producers and expansion of uremic toxin-generating bacteria, in the accumulation of nephrotoxic metabolites (such as indoxyl sulfate, p-cresyl sulfate and trimethylamine N-oxide) is summarized. These toxins promote oxidative stress, inflammation and fibrosis, accelerating renal decline. By contrast, microbially derived short-chain fatty acids exert protective effects. Although therapeutic strategies targeting the gut microbiome (including probiotics, prebiotics and adsorbents) and fecal microbiota transplantation (targeting the gut microbiome) exhibit potential in modulating toxin levels, evidence for clinical endpoint benefit remains insufficient. In the present review, mechanistic insights were critically evaluated, clinical intervention studies are systematically summarized in tabulated form and a roadmap for personalized, microbiota-informed therapeutic strategies is proposed.
SN - 1791-2997
SN - 1791-3004
ER -