Microbiome Derived Metabolites in CKD and ESRD

The gut microbiome encompasses the complex and vast landscape of microbes that normally colonize the gastrointestinal tract. Its quintessentially symbiotic presence is reflected in its role in various physiological processes vital to human health. A converse entity—gut dysbiosis refers to a disrupted microbial state in which adverse metabolites, endotoxins, and other pro-inflammatory mediators are known to accumulate. Downstream consequences include inflammation, immune dysregulation, cardiovascular disease, obesity, insulin resistance, and progression of underlying chronic kidney disease. Current insights into the origins and mechanisms of such pathogenic mediators and metabolites are reviewed here.