Contribution of the intestinal microbiome towards the human metabolome in chronic kidney disease: investigating the gut-kidney axis.

Chronic kidney disease is one of the epidemics of modern times. As kidney function falls, numerous waste products accumulate in the blood. These waste products originate in part from gut bacteria and are thought to be toxic to the body, resulting in cardiac disease and in increased mortality. The link between gut bacteria and chronic kidney disease is often referred to as the gut-kidney axis. We will examine three distinct features of the gut-kidney axis. First, we will investigate whether a reduced kidney function has an influence on the gut microbes, thereby increasing the production of waste products. Second, a study will be initiated in patients with kidney dysfunction to explore the effects of dietary supplementation with a prebiotic on the gut microbial flora and generation of their detrimental by-products. Third, we will examine whether constipation is associated with an increased production of microbial waste products and can be modified by accelerating the gut transit. In conclusion, we aim to explore the interplay between gut bacteria producing waste products and chronic kidney disease. A better understanding of these interactions and the initiation of two interventional studies could ultimately lead to novel treatment strategies in patients with kidney dysfunction.