International Urology and Nephrology

, Volume 51, Issue 12, pp 2209–2226 | Cite as

The gut microbiota and its relationship with chronic kidney disease

  • Consuelo Plata
  • Cristino Cruz
  • Luz G. Cervantes
  • Victoria RamírezEmail author
Nephrology - Review


Chronic kidney disease (CKD) is a worldwide health problem, because it is one of the most common complications of metabolic diseases including obesity and type 2 diabetes. Patients with CKD also develop other comorbidities, such as hypertension, hyperlipidemias, liver and cardiovascular diseases, gastrointestinal problems, and cognitive deterioration, which worsens their health. Therapy includes reducing comorbidities or using replacement therapy, such as peritoneal dialysis, hemodialysis, and organ transplant. Health care systems are searching for alternative treatments for CKD patients to mitigate or retard their progression. One new topic is the study of uremic toxins (UT), which are excessively produced during CKD as products of food metabolism or as a result of the loss of renal function that have a negative impact on the kidneys and other organs. High urea concentrations significantly modify the microbiota in the gut also, cause a decrease in bacterial strains that produce anti-inflammatory and fuel molecules and an increase in bacterial strains that can metabolize urea, but also produce UT, including indoxyl sulfate and p-cresol sulfate. UT activates several cellular processes that induce oxidative environments, inflammation, proliferation, fibrosis development, and apoptosis; these processes mainly occur in the gut, heart, and kidney. The study of the microbiota during CKD allowed for the implementation of therapy schemes to try to reduce the circulating concentrations of UT and reduce the damage. The objective of this review is to show an overview to know the main UT produced in end-stage renal disease patients, and how prebiotics and probiotics intervention acts as a helpful tool in CKD treatment.


Chronic kidney disease Microbiota Dysbiosis Probiotics Prebiotics 



This work was supported by Grant no. 155700 from the National Council of Science and Technology (CONACyT) to VR.

Compliance ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Nutrición Salvador ZubiránMexico CityMexico
  2. 2.Departamento de Farmacología, Instituto Nacional de Cardiología Ignacio ChávezMexico CityMexico
  3. 3.Departamento de Cirugía Experimental, Instituto Nacional de Nutrición Salvador ZubiránMexico CityMexico

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