The Chronic Kidney Disease - Colonic Axis.
Semin Dial
; 28(5): 459-63, 2015.
Article
en En
| MEDLINE
| ID: mdl-25855516
Chronic kidney disease (CKD) has long been known to cause significant gastrointestinal and colonic pathology. Recent advances in understanding of the role of colonic bacterial microbiome and its function and composition in health and disease have revealed previously unappreciated effects of CKD-associated colonic pathology on the development of uremic complications. CKD can result in profound changes in the microbiome composition and biosynthetic pattern, and the structure and function of the colon. Increases in bacteria that produce urease, uricase, p-cresol- and indole-forming enzymes and the depletion of bacteria that possess short chain fatty acid forming enzymes have been described in human and animal models. Disruption of the colonic epithelial tight junction in different animal models of CKD has been reported and is largely due to the conversion of luminal urea to ammonia by urease possessing bacteria. Together, these changes contribute to the pathogenesis of systemic inflammation and uremic toxicity by allowing the translocation of endotoxin and microbial fragments into the circulation. Additionally, colonic bacteria are the main source of several well-known pro-inflammatory uremic toxins such as indoxyl sulfate, P-cresol sulfate. This review is intended to provide an overview of the effects of CKD on the colonic microbiome and the intestinal epithelial barrier structure and function and their role in the pathogenesis the systemic inflammation and uremic toxicity.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Colon
/
Enfermedades del Colon
/
Insuficiencia Renal Crónica
Tipo de estudio:
Etiology_studies
Límite:
Humans
Idioma:
En
Revista:
Semin Dial
Asunto de la revista:
NEFROLOGIA
Año:
2015
Tipo del documento:
Article
Pais de publicación:
Estados Unidos