CORRECTION OF MICROBIOTA CHANGES IN PATIENTS WITH CHRONIC KIDNEY FAILURE IN KHOREZM REGION
##semicolon##
chronic kidney disease##common.commaListSeparator## gut microbiota##common.commaListSeparator## probiotics##common.commaListSeparator## synbiotics##common.commaListSeparator## uremic toxinsAbstrak
Chronic kidney disease (CKD) is associated with gut microbiota dysbiosis, which exacerbates disease progression through increased production of uremic toxins and systemic inflammation. The Khorezm region presents unique dietary and environmental factors influencing microbiota composition. To review current literature on microbiota alterations in CKD, evaluate therapeutic interventions, and present clinical observations on microbiota correction in CKD patients from the Khorezm region. Literature review combined with a prospective observational study of 30 CKD patients (stages 3–5) receiving probiotic and dietary interventions. Literature confirms dysbiosis characterized by decreased SCFA-producing bacteria and increased proteolytic species. Clinical observations showed that 12 weeks of probiotic and prebiotic supplementation combined with dietary fiber increase resulted in significant reduction of serum uremic toxins (indoxyl sulfate, p-cresyl sulfate), inflammatory markers (CRP, IL-6), and improvement in gastrointestinal symptoms. Targeted microbiota correction is effective in improving biochemical and clinical parameters in CKD patients in Khorezm. Larger controlled studies are recommended
##submission.citations##
1. Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389(10075):1238–52.
2. Vaziri ND, Wong J, Pahl M, Piceno YM, Yuan J, DeSantis TZ, et al. Chronic kidney disease alters intestinal microbial flora. Kidney Int. 2013;83(2):308–15.
3. Ramezani A, Raj DS. The gut microbiome, kidney disease, and targeted interventions. J Am Soc Nephrol. 2014;25(4):657–70.
4. Koppe L, Pillon NJ, Vella RE, Croze ML, Pelletier CC, Chambert S, et al. Mechanisms and consequences of gut microbiota dysbiosis in chronic kidney disease. Kidney Int. 2016;90(4):743–55.
5. Krishnamurthy VM, Wei G, Baird BC, Murtaugh MA, Chonchol M, Greene T, et al. High dietary fiber intake is associated with decreased inflammation in chronic kidney disease. Am J Clin Nutr. 2012;96(2):302–9.
6. Olimkhonova G, Toirova N, Karimov A. Gut microbiota changes in CKD patients in Uzbekistan. Tashkent Med J. 2021;(2):34–40. [In Uzbek]
7. Wong J, Piceno YM, DeSantis TZ, Pahl M, Andersen GL, Vaziri ND. Expansion of urease- and uricase-containing, indole- and p-cresol-forming bacteria in the gut microbiota of patients with chronic kidney disease. Kidney Int. 2014;85(1):130–8.
8. Vaziri ND, Yuan J, Nazertehrani S, Ni Z, Liu S. Role of uremic toxins in gastrointestinal barrier dysfunction and disruption of epithelial tight junctions in chronic kidney disease. Nephrol Dial Transplant. 2013;28(11):2546–53.
9. Rossi M, Johnson DW, Morrison M, Pascoe EM, Coombes JS, Forbes JM, et al. Synbiotics Efficacy in Chronic Kidney Disease: A Randomized Controlled Trial. Clin J Am Soc Nephrol. 2021;16(3):497–509.
10. Hida M, Tomofuji T, Maruyama T, Sawada K, Maekawa Y, Azuma T. Clinical and microbiome outcomes of synbiotics in chronic renal failure. Nephrology (Carlton). 2020;25(4):318–26.
11. Hu X, Zhong Z, Li L, Wang Y, Shi Z, Yan W. Alterations in gut microbiota in chronic kidney disease: diversity, composition, and function. Front Cell Infect Microbiol. 2020;10:420.
