The gut-kidney axis.
The host-gut microbiota interaction has been the focus of increasing interest in recent years. It has been determined that this complex interaction is not only essential to many aspects of normal 'mammalian' physiology but that it may also contribute to a multitude of ailments, from the obvious case...
| Publicado en: | Pediatric Nephrology Vol. 32; no. 11; pp. 2005 - 2015 |
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| Autores principales: | , , |
| Formato: | pictorial review tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125425741&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125425741 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2017 vid: 32 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 125425741 125425741 144032004 125425741 10.1007/s00467-016-3527-x 125425741 ppf: 2005 ppct: 10 formats: fmt: @attributes: type: P tig: atl: The gut-kidney axis. aug: au: Evenepoel, Pieter Poesen, Ruben Meijers, Björn sug: subj: Gut Microbiota Metabolism Uremia Metabolism Renal Insufficiency, Chronic Metabolism Uremia Etiology Kidney Metabolism Renal Insufficiency, Chronic Etiology Renal Insufficiency, Chronic Physiopathology Uremia Complications Gut Microbiota Pathology Indoles Bacterial Toxins Endotoxins Proteins Metabolism Fermentation Phenols Metabolism Choline Metabolism Carnitine Metabolism ab: The host-gut microbiota interaction has been the focus of increasing interest in recent years. It has been determined that this complex interaction is not only essential to many aspects of normal 'mammalian' physiology but that it may also contribute to a multitude of ailments, from the obvious case of inflammatory bowel disease to (complex) diseases residing in organs outside the gut. An increasing body of evidence indicates that crosstalk between host and microbiota is pathophysiologically relevant in patients with chronic kidney disease (CKD). Interactions are bidirectional; on the one hand, uremia affects both the composition and metabolism of the gut microbiota and, on the other hand, important uremic toxins originate from microbial metabolism. In addition, gut dysbiosis may induce a disruption of the epithelial barrier, ultimately resulting in increased exposure of the host to endotoxins. Due to dietary restrictions and gastrointestinal dysfunctions, microbial metabolism shifts to a predominantly proteolytic fermentation pattern in CKD. Indoxyl sulfate and p-cresyl sulfate, both end-products of protein fermentation, and trimethylamine- N-oxide, an end-product of microbial choline and carnitine metabolism, are prototypes of uremic toxins originating from microbial metabolism. The vascular and renal toxicity of these co-metabolites has been demonstrated extensively in experimental and clinical studies. These co-metabolites are an appealing target for adjuvant therapy in CKD. Treatment options include dietary therapy, prebiotics, probiotics and host and bacterial enzyme inhibitors. Final proof of the concept should come from randomized controlled and adequately powered intervention studies. pubtype: Academic Journal doctype: pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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