El papel del microbioma intestinal en la progresión de la enfermedad renal
Resumen
La microbiota intestinal desempeña un papel clave en el desarrollo y la progresión de las enfermedades renales. La disbiosis intestinal favorece la inflamación sistémica, la producción de toxinas urémicas y el deterioro de la barrera intestinal, contribuyendo al daño renal y a las complicaciones cardiovasculares. La interacción bidireccional del eje intestino–riñón convierte al microbioma en un potencial objetivo terapéutico para mejorar el pronóstico de la enfermedad renal crónica.
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Prieto PA. Fundamentos de la microbiota y el microbioma. Avances en investigación sobre el microbioma intestinal humano. Medicina. 2023;45(2):229-246.
Joos R, Boucher K, Lavelle A, et al. Examining the healthy human microbiome concept. Nat Rev Microbiol. 2025;23:192–205. doi:10.1038/s41579-024-01107-0.
Tourountzis T, Lioulios G, Fylaktou A, Moysidou E, Papagianni A, Stangou M. Microbiome in chronic kidney disease. Life. 2022;12(10):1513.
Qu L, Jiao B. The interplay between immune and metabolic pathways in kidney disease. Cells. 2023;12(12):1584.
Karlinsey K, Qu L, Matz AJ, Zhou B. A novel strategy to dissect multifaceted macrophage function in human diseases. J Leukoc Biol. 2022;112(6):1535–1542.
Basso PJ, Andrade-Oliveira V, Câmara NOS. Targeting immune cell metabolism in kidney diseases. Nat Rev Nephrol. 2021;17(7):465–480.
Xu L, Guo J, Moledina DG, Cantley LG. Immune-mediated tubule atrophy promotes acute kidney injury to chronic kidney disease transition. Nat Commun. 2022;13(1):4892.
Liu Y, Lv Y, Zhang T, Huang T, Lang Y, Sheng Q, et al. T cells and their products in diabetic kidney disease. Front Immunol. 2023;14:1084448.
Gao M, Wang J, Zang J, An Y, Dong Y. The mechanism of CD8+ T cells for reducing myofibroblasts accumulation during renal fibrosis. Biomolecules. 2021;11(7):990.
Stamatelou, K., & Goldfarb, D. S. (2023). Epidemiology of Kidney Stones. Healthcare, 11(3), 424. https://doi.org/10.3390/healthcare11030424
Moftakhar L, Jafari F, Johari MG, Rezaeianzadeh R, Hosseini SV, Rezaianzadeh A. Prevalence and risk factors of kidney stone disease in population aged 40–70 years old in Kharameh cohort study: a cross-sectional population-based study in southern Iran. BMC Urol. 2022;22(205).
Xiang L, Jin X, Liu Y, Ma Y, Jian Z, Wei Z, et al. Prediction of the occurrence of calcium oxalate kidney stones based on clinical and gut microbiota characteristics. World J Urol. 2022;40(1):221–227.
Yuan C, Jin X, He Y, Liu Y, Xiang L, Wang K. Association of dietary patterns with gut microbiota in kidney stone and non-kidney stone individuals. Urolithiasis. 2022;50(4):389–399.
Zampini A, Nguyen AH, Rose E, Monga M, Miller AW. Defining dysbiosis in patients with urolithiasis. Sci Rep. 2019;9(1):5425.
Kachroo N, Monga M, Miller AW. Comparative functional analysis of the urinary tract microbiome for individuals with or without calcium oxalate calculi. Urolithiasis. 2022;50(3):303–317.
Wang X, Krambeck AE, Williams JC Jr, Tang X, Rule AD, Zhao F, et al. Distinguishing characteristics of idiopathic calcium oxalate kidney stone formers with low amounts of Randall's plaque. Clin J Am Soc Nephrol. 2014;9(10):1757–1763.
Kachroo N, Lange D, Penniston KL, Stern J, Tasian G, Bajic P, et al. Meta-analysis of clinical microbiome studies in urolithiasis reveal age, stone composition, and study location as the predominant factors in urolithiasis-associated microbiome composition. mBio. 2021;12:e02007-21.
Cockwell P, Fisher LA. The global burden of chronic kidney disease. Lancet. 2020;395(10225):662–664.
Zarantonello D, Rhee CM, Kalantar-Zadeh K, Brunori G. Novel conservative management of chronic kidney disease via dialysis-free interventions. Curr Opin Nephrol Hypertens. 2021;30(1):97–107.
Suparan K, Sriwichaiin S, Chattipakorn N, Chattipakorn SC. Human blood bacteriome: eubiotic and dysbiotic states in health and diseases. Cells. 2022;11(13):2015.
Li N, Wang Y, Wei P, Min Y, Yu M, Zhou G, et al. Causal effects of specific gut microbiota on chronic kidney diseases and renal function—a two-sample Mendelian randomization study. Nutrients. 2023;15(2):360.
Asgharian M, Gholizadeh P, Kafil HS, Ghojazadeh M, Samadi A, Soleymani J, et al. Correlation of inflammatory biomarkers with the diversity of Bacteroidaceae, Bifidobacteriaceae, Prevotellaceae and Lactobacillaceae families in the intestinal microbiota of patients with end stage renal disease. Adv Med Sci. 2022;67(2):304–310.
Cardenas VM, Miranda VRM. Eje intestino–riñón: avances recientes y aplicaciones clínicas en nefrología pediátrica y del adulto. Nutr Clin Diet Hosp. 2025;45(4).
Kemp JA, Ribeiro M, Borges NA, Cardozo L, Fouque D, Mafra D. Dietary intake and gut microbiome in chronic kidney disease. Clin J Am Soc Nephrol. 2025;10-2215.
Di Paola R, De A, Izhar R, Abate M, Zappavigna S, Capasso A, et al. Possible effects of uremic toxins p-cresol, indoxyl sulfate, p-cresyl sulfate on the development and progression of colon cancer in patients with chronic renal failure. Genes. 2023;14(6):1257.
Berg AH, Kumar S, Karumanchi SA. Indoxyl sulfate in uremia: an old idea with updated concepts. J Clin Invest. 2022;132(1).
Lecamwasam A, Nelson TM, Rivera L, Ekinci EI, Saffery R, Dwyer KM. Gut microbiome composition remains stable in individuals with diabetes-related early to late stage chronic kidney disease. Biomedicines. 2020;9:19.
Zhang W, Miikeda A, Zuckerman J, Jia X, Charugundla S, Zhou Z, et al. Inhibition of microbiota-dependent TMAO production attenuates chronic kidney disease in mice. Sci Rep. 2021;11(1):518.
Zhou Z, Jin H, Ju H, Sun M, Chen H, Li L. Circulating trimethylamine-N-oxide and risk of all-cause and cardiovascular mortality in patients with chronic kidney disease: a systematic review and meta-analysis. Front Med. 2022;9:828343.
Hu J, Wei S, Gu Y, Wang Y, Feng Y, Sheng J, et al. Gut mycobiome in patients with chronic kidney disease was altered and associated with immunological profiles. Front Immunol. 2022;13:843695.
Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709–733. doi:10.1016/S0140-6736(20)30045-3.
Li F, Wang M, Wang J, Li R, Zhang Y. Alterations to the gut microbiota and their correlation with inflammatory factors in chronic kidney disease. Front Cell Infect Microbiol. 2019;9:206. doi:10.3389/fcimb.2019.00206.
Fiers WD, Leonardi I, Iliev ID. From birth and throughout life: fungal microbiota in nutrition and metabolic health. Annu Rev Nutr. 2020;40:323–343. doi:10.1146/annurev-nutr-013120-043659.
Shankar J. Food habit associated mycobiota composition and their impact on human health. Front Nutr. 2021;8:773577. doi:10.3389/fnut.2021.773577.
Sciavilla P, Strati F, Di Paola M, Modesto M, Vitali F, Cavalieri D, et al. Gut microbiota profiles and characterization of cultivable fungal isolates in IBS patients. Appl Microbiol Biotechnol. 2021;105:3277–3288. doi:10.1007/s00253-021-11264-4.
Khiabani SA, Haghighat S, Khosroshahi HT, Asgharzadeh M, Kafil HS. Diversity of Bacteroidaceae family in gut microbiota of patients with chronic kidney disease and end stage renal disease. Health Promot Perspect. 2023;13(3):237.
Wong SP, Rubenzik T, Zelnick L, Davison SN, Louden D, Oestreich T, Jennerich AL. Long-term outcomes among patients with advanced kidney disease who forgo maintenance dialysis: a systematic review. JAMA Netw Open. 2022;5(3):e222255.
Nikolic-Paterson DJ, Grynberg K, Ma FY. JUN amino terminal kinase in cell death and inflammation in acute and chronic kidney disease. Integr Med Nephrol Androl. 2021;8(1):10.
Ebrahimzadeh Leylabadlo H, Ghotaslou R, Feizabadi MM, Farajnia S, Moaddab SY, Ganbarov K, et al. The critical role of Faecalibacterium prausnitzii in human health: an overview. Microb Pathog. 2020;149:104344. doi:10.1016/j.micpath.2020.104344.
Amini Khiabani S, Haghighat S, Tayebi Khosroshahi H, Asgharzadeh M, Samadi Kafil H. Clostridium species diversity in gut microbiota of patients with renal failure. Microb Pathog. 2022;169:105667. doi:10.1016/j.micpath.2022.105667.
Lano G, Burtey S, Sallée M. Indoxyl sulfate, a uremic endotheliotoxin. Toxins (Basel). 2020;12(4):229.
Li Q, Zhang S, Wu QJ, Xiao J, Wang ZH, Mu XW, et al. Serum total indoxyl sulfate levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study. BMC Nephrol. 2022;23:231.
Laiola M, Koppe L, Larabi A, et al. Toxic microbiome and progression of chronic kidney disease: insights from a longitudinal CKD-Microbiome Study. Gut 2025;74:1624–1637. doi: 10.1136/gutjnl-2024-334634
Monticolo M, Mucha K, Foroncewicz B. Lupus Nephritis and Dysbiosis. Biomedicines 2023;11(4):1165. doi: 10.3390/biomedicines11041165
Zhang L, Song P, Zhang X, Metea C, Schleisman M, Karstens L, et al. Alpha-glucosidase inhibitors alter gut microbiota and ameliorate collagen-induced arthritis. Front Pharmacol. 2020;10:1684.
Saadat YR, Niknafs B, Khatibi SMH, Ardalan M, Majdi H, Bahmanpoor Z, et al. Gut microbiota: an overlooked effect of phosphate binders. Eur J Pharmacol. 2020;868:172892.
Douglas GM, Maffei VJ, Zaneveld JR, Yurgel SN, Brown JR, Taylor CM, et al. PICRUSt2 for prediction of metagenome functions. Nat Biotechnol. 2020;38:685–688.
Feng Z, Wang T, Dong S, et al. Association between Gut Dysbiosis and Chronic Kidney Disease: A Narrative Review of the Literature. J Int Med Res. 2021;49.
Lim YJ, Sidor NA, Tonial NC, et al. Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease. Toxins. 2021;13:142.
Espi M, Koppe L, Fouque D, Thaunat O. Chronic Kidney Disease-Associated Immune Dysfunctions: Impact of Protein-Bound Uremic Retention Solutes on Immune Cells. Toxins. 2020;12:300.
Simões-Silva L, Araujo R, Pestana M, et al. Peritoneal Microbiome in End-Stage Renal Disease Patients and the Impact of Peritoneal Dialysis Therapy. Microorganisms. 2020;8:173.
Flythe JE, Watnick S. Dialysis for chronic kidney failure: a review. JAMA. 2024.
Salvadori M, Tsalouchos A. Microbiota, renal disease and renal transplantation. World J Transplant. 2021;11(3):16.
Derechos de autor 2026 Dávila Briones Karina Graciela, Romero León Josué Ernesto, Parrales Herrera Miguel Ángel, Lozano Alcívar Carla María

Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.









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