Journal of Clinical Medicine · 9 authors, 4 centres
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This systematic review analyzed 69 studies to show that gut microbiota diversity is decreased and composition is altered in chronic kidney disease (CKD) patients, even at early stages, with specific bacterial patterns linked to disease progression and mortality. The main limitation is the need for large randomized clinical trials to confirm the impact of microbiota modulation on clinical outcomes.
This systematic review synthesized evidence from 69 studies on gut microbiota in chronic kidney disease (CKD). The background establishes a bidirectional kidney-gut axis where dysbiosis may promote CKD progression and is linked to systemic inflammation and cardiovascular risk. Key results indicate that gut microbiota diversity is significantly decreased in CKD patients compared to healthy controls, with specific alterations such as reduced Roseburia abundance (p < 0.001 in ESKD) and increased Proteobacteria. Discriminatory models using microbiota data showed high predictive power for conditions like diabetic nephropathy (AUC = 0.972). Associations were observed between dysbiosis and outcomes like peritonitis, inflammation, and mortality, with distinct microbiota patterns in deceased ESKD patients. Some studies suggested beneficial effects of synbiotic and probiotic therapies on gut flora composition. Limitations include the predominance of observational designs, data inconsistency, and the need for larger randomized trials to establish causality and clinical impact.
