Inflammation and gut dysbiosis as drivers of CKD–MBD

Evenepoel, Pieter; Stenvinkel, Peter; Shanahan, Catherine M.; Pacifici, Roberto

doi:10.1038/s41581-023-00736-7

Cited by 17 publications

(5 citation statements)

References 212 publications

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“…These results may indicate a link between microbiota and VC in CKD patients on peritoneal dialysis [ 52 ] ( Table 1 ). Such results from similar studies led to the hypothesis that inflammation and gut dysbiosis are important drivers of CKD–MBD [ 85 ]. An association between dietary inflammatory index and cardiovascular disease and mortality was recently proven [ 86 ].…”

Section: Uremic Toxins Microbiota Fibers and Vascular Calcification I...mentioning

confidence: 99%

Food to Prevent Vascular Calcification in Chronic Kidney Disease

Moldovan,

Rusu,

Potra

et al. 2024

Nutrients

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Vascular calcification (VC) is a consequence of chronic kidney disease (CKD) which is of paramount importance regarding the survival of CKD patients. VC is far from being controlled with actual medication; as a result, in recent years, diet modulation has become more compelling. The concept of medical nutritional therapy points out the idea that food may prevent or treat diseases. The aim of this review was to evaluate the influence of food habits and nutritional intervention in the occurrence and progression of VC in CKD. Evidence reports the harmfulness of ultra-processed food, food additives, and animal-based proteins due to the increased intake of high absorbable phosphorus, the scarcity of fibers, and the increased production of uremic toxins. Available data are more supportive of a plant-dominant diet, especially for the impact on gut microbiota composition, which varies significantly depending on VC presence. Magnesium has been shown to prevent VC but only in experimental and small clinical studies. Vitamin K has drawn considerable attention due to its activation of VC inhibitors. There are positive studies; unfortunately, recent trials failed to prove its efficacy in preventing VC. Future research is needed and should aim to transform food into a medical intervention to eliminate VC danger in CKD.

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Section: Uremic Toxins Microbiota Fibers and Vascular Calcification I...mentioning

confidence: 99%

Food to Prevent Vascular Calcification in Chronic Kidney Disease

Moldovan,

Rusu,

Potra

et al. 2024

Nutrients

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“…Both small and large uremic toxins and especially protein-bound uremic toxins predispose CKD or HD patients to uremic VC [ 53 ]. Uremia promotes intestinal dysbiosis and disrupts the intestinal epithelial barrier [ 54 ], thus allowing live bacteria, endotoxins (lipopolysaccharide), and gut-derived uremic toxins to enter the systemic circulation, a condition commonly known as “leaky gut” [ 55 ]. In CKD, the pathogenesis of a leaky gut is a multifactorial process driven by sympathetic hyperactivity, intestinal congestion, hypogonadism, increased urine ammonia and ammonium hydroxide exposure, and decreased butyrate production [ 55 ].…”

Section: Reviewmentioning

confidence: 99%

“…Finally, increased intestinal permeability is caused by altered zonulin expression. Hence, the use of the zonulin antagonist larazotide may improve the integrity of the intestinal barrier, thereby reducing the absorption of toxins [ 55 ]. Given that numerous vasotoxic compounds are derived from gut microbiota-mediated metabolism, the gut is increasingly recognized as a promising target for therapy [ 57 ].…”

Section: Reviewmentioning

confidence: 99%

Pathogenesis and Mechanism of Uremic Vascular Calcification

Shen

2024

Cureus

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“…Among all the adverse outcomes caused by CKD, cardiovascular disease (CVD), as a leading cause of death, is one of the most important and severe (2,4,5). Patients with CKD typically present with hypertension, atherosclerosis, lipid metabolism abnormalities, mineral and bone disorders, chronic inflammation, and oxidative stress (6)(7)(8)(9)(10)(11)(12). These alterations commonly result from a decline in the glomerular filtration rate (9).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with CKD typically present with hypertension, atherosclerosis, lipid metabolism abnormalities, mineral and bone disorders, chronic inflammation, and oxidative stress (6)(7)(8)(9)(10)(11)(12). These alterations commonly result from a decline in the glomerular filtration rate (9). Notably, chronic inflammation and oxidative stress can exacerbate endothelial damage, leading to the formation of unstable atherosclerotic plaques (6,(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Systemic Inflammatory Response Index (SIRI) is associated with all-cause mortality and cardiovascular mortality in population with chronic kidney disease: evidence from NHANES (2001–2018)

Gu,

Xia,

Qing

et al. 2024

Front. Immunol.

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ObjectiveTo examine the correlation between SIRI and the probability of cardiovascular mortality as well as all-cause mortality in individuals with chronic kidney disease.MethodsA cohort of 3,262 participants from the US National Health and Nutrition Examination Survey (NHANES) database were included in the study. We categorized participants into five groups based on the stage of chronic kidney disease. A weighted Cox regression model was applied to assess the relationship between SIRI and mortality. Subgroup analyses, Kaplan–Meier survival curves, and ROC curves were conducted. Additionally, restricted cubic spline analysis was employed to elucidate the detailed association between SIRI and hazard ratio (HR).ResultsThis study included a cohort of 3,262 individuals, of whom 1,535 were male (weighted proportion: 42%), and 2,216 were aged 60 or above (weighted proportion: 59%). Following adjustments for covariates like age, sex, race, and education, elevated SIRI remained a significant independent risk factor for cardiovascular mortality (HR=2.50, 95%CI: 1.62-3.84, p<0.001) and all-cause mortality (HR=3.02, 95%CI: 2.03-4.51, p<0.001) in CKD patients. The restricted cubic spline analysis indicated a nonlinear relationship between SIRI and cardiovascular mortality, with SIRI>1.2 identified as an independent risk factor for cardiovascular mortality in CKD patients.ConclusionHeightened SIRI independently poses a risk for both all-cause and cardiovascular mortality in chronic kidney disease patients, with potentially heightened significance in the early stages (Stage I to Stage III) of chronic kidney disease.

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Inflammation and gut dysbiosis as drivers of CKD–MBD

Cited by 17 publications

References 212 publications

Food to Prevent Vascular Calcification in Chronic Kidney Disease

Food to Prevent Vascular Calcification in Chronic Kidney Disease

Pathogenesis and Mechanism of Uremic Vascular Calcification

Systemic Inflammatory Response Index (SIRI) is associated with all-cause mortality and cardiovascular mortality in population with chronic kidney disease: evidence from NHANES (2001–2018)

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