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

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.

Natural intestinal metabolite xylitol reduces BRD4 levels to mitigate renal fibrosis

“…14 It is generally accepted that there is a complex interplay between the kidneys and the intestines. 15 For example, in patients with CKD, toxic substances, such as urotoxins and uric acid, accumulate in the body owing to the reduced excretory function of the kidneys, changing the microenvironment in the intestines. [16][17][18] A growing body of evidence suggests that gut flora has great potential for studying delayed renal fibrosis.…”

The role of vitamin D in pediatric systemic lupus erythematosus - a double pawn in the immune and microbial balance

“…Regarding the microbiota, it is important to know that it is in a perpetual change since the neonatal period, influencing the evolutionary course and the response to the treatment of various pathologies through gut-vital organ axes ( 76 – 82 ). Another factor inducing intestinal inflammation and dysbiosis is stress ( 83 ).…”

Clinical Perspectives of Gut Microbiota in Patients with Chronic Kidney Disease and End-Stage Kidney Disease: Where Do We Stand?

“…GMs intrinsic variety and diversity among those populations are frequently overlooked in research [ 164 ]. Various factors, such as dietary patterns, pharmaceutical interventions, and the presence of concurrent medical conditions, can potentially impact the diversity of GM [ 165 , 166 ]. It is imperative to incorporate strategies to control relevant factors and address individual variations [ 166 ].…”