AI Article Synopsis
- Gut dysbiosis in chronic kidney disease (CKD) has been linked to anemia due to factors like increased uremic toxins, inflammation from gut barrier issues, and reduced production of beneficial short-chain fatty acids (SCFAs).
- Addressing gut dysbiosis can help manage anemia in CKD patients by reducing harmful medications, incorporating dietary changes, and using prebiotics or probiotics to enhance beneficial gut bacteria.
- Improving gut health in CKD not only alleviates anemia symptoms but can also boost the effectiveness of treatments like erythropoiesis-stimulating agents (ESAs) in patients unresponsive to standard therapies.
Article Abstract
The gut dysbiosis present in chronic kidney disease (CKD) has been associated with anemia. Factors such as the accumulation of gut-derived uremic toxins, increased gut barrier permeability-induced inflammation, and a reduced intestinal production of short-chain fatty acids (SCFAs), all associated with changes in the intestinal microbiota composition in CKD, may lead to the development or worsening of anemia in renal patients. Understanding and addressing these mechanisms related to gut dysbiosis in CKD patients can help to delay the development of anemia and improve its control in this population. One approach is to avoid or reduce the use of drugs linked to gut dysbiosis in CKD, such as phosphate binders, oral iron supplementation, antibiotics, and others, unless they are indispensable. Another approach involves introducing dietary changes that promote a healthier microbiota and/or using prebiotics, probiotics, or symbiotics to improve gut dysbiosis in this setting. These measures can increase the presence of SCFA-producing saccharolytic bacteria and reduce proteolytic bacteria, thereby lowering the production of gut-derived uremic toxins and inflammation. By ameliorating CKD-related gut dysbiosis, these strategies can also improve the control of renal anemia and enhance the response to erythropoiesis-stimulating agents (ESAs) in ESA-resistant patients. In this review, we have explored the relationship between gut dysbiosis in CKD and renal anemia and propose feasible solutions, both those already known and potential future treatments.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598790 | PMC |
| http://dx.doi.org/10.3390/toxins16110495 | DOI Listing |
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