The role of the gut micro biota in kidney disease

There is increasing evidence of the influence of the gut microbiota on kidney diseases and precursors such as hypertension, diabetes, cardiovascular diseases and its complications, such as stroke, heart failure, and myocardial infarction. This is no surprising considering that the most common risk factor for hypertension, such as age, sex medication, and diet, can also impact the gut microbiota.

For example, sodium and fermentable fiber have been studied in relation to both hypertension and the gut microbe Inflammation and fibrosis are the important pathophysiologic processes in diabetic kidney disease (DKD), which is induced by epigenetics, especially histone posttranslational modification (HPTMs). Have been indicated to play different roles in the repair of DNA damage.

Recent reports highlighted that butyrate, one of the short-chain fatty acids (SCFAs) primarily originated from the fermentation of dietary fiber in the gut, attenuates inflammation and fibrosis in the prevention and treatment of DKD, however the molecular mechanisms are still unclear.

Histone lysine butyrylation (Kbu), a novel histone modification marker induced by butyrate, has been found to be involved in the regulation of pathophysiological processes. To reveal the mechanisms of butyrate-induced histone (Kbu), in the prevention and treatment of DKD, both DKD models in vivo and in vitro were treated with sodium butyrate (NaB). The results confirmed that exogenous NaB improved the disorder of glucose and lipid metabolism, prevented proteinuria and renal failure, and inhibited renal inflammation and fibrosis

New treatment options in the form of prebiotics (dietary fiber), probiotics (lactobacillus spp) and postbiotics (the short-chain fatty acids acetate, propionate, and butyrate) have all been demonstrated to be beneficial in the kidney disease.

We should include short-chain fatty acids such as butyric acid in our patients with kidney disease regardless of the etiology to maintain the intestinal microbiota and avoid dysbiosis that causes inflammation, proteinuria, endothelial dysfunction.