Crosstalk between intestine and kidney. Revival of an ancient link

Abstract

Chronic kidney disease (CKD) is associated with systemic inflammation. The latter accelerates comorbidities that are associated with CKD (cardiovascular disease, anemia, infections, cachexia and several other conditions), shortens life span and greatly impairs the quality of life. Recently the attention has been focused intestine and intestinal microbiota as sources of systemic inflammation. On one hand, the microbiota promotes the production of uraemic solute with a biological impact on the progression of kidney failure and vascular diseases. On the other hand, the uraemic status alters the composition of the intestinal microbiota and the structure of the epithelial barrier, causing the translocation of both microbiota and uraemic toxins into the blood stream. Several approaches have recently been tested, including dietary measures, prebiotics, synbiotics and intestinal sorbents in order to reduce the generation and serum concentration of uraemic toxins.