Phosphate,Microbiota and CKD |
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Authors: | Chiara Favero,Sol Carriazo,Leticia Cuarental,Raul Fernandez-Prado,Elena Gom -Garc s,Maria Vanessa Perez-Gomez,Alberto Ortiz,Beatriz Fernandez-Fernandez,Maria Dolores Sanchez-Ni o |
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Affiliation: | 1.Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Av Reyes Católicos 2, 28040 Madrid, Spain; (C.F.); (S.C.); (L.C.); (R.F.-P.); (E.G.-G.); (M.V.P.-G.);2.Red de Investigacion Renal (REDINREN), Av Reyes Católicos 2, 28040 Madrid, Spain;3.School of Medicine, Department of Pharmacology and Therapeutics, Universidad Autonoma de Madrid, 28049 Madrid, Spain |
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Abstract: | Phosphate is a key uremic toxin associated with adverse outcomes. As chronic kidney disease (CKD) progresses, the kidney capacity to excrete excess dietary phosphate decreases, triggering compensatory endocrine responses that drive CKD-mineral and bone disorder (CKD-MBD). Eventually, hyperphosphatemia develops, and low phosphate diet and phosphate binders are prescribed. Recent data have identified a potential role of the gut microbiota in mineral bone disorders. Thus, parathyroid hormone (PTH) only caused bone loss in mice whose microbiota was enriched in the Th17 cell-inducing taxa segmented filamentous bacteria. Furthermore, the microbiota was required for PTH to stimulate bone formation and increase bone mass, and this was dependent on bacterial production of the short-chain fatty acid butyrate. We review current knowledge on the relationship between phosphate, microbiota and CKD-MBD. Topics include microbial bioactive compounds of special interest in CKD, the impact of dietary phosphate and phosphate binders on the gut microbiota, the modulation of CKD-MBD by the microbiota and the potential therapeutic use of microbiota to treat CKD-MBD through the clinical translation of concepts from other fields of science such as the optimization of phosphorus utilization and the use of phosphate-accumulating organisms. |
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Keywords: | chronic kidney disease microbiota phosphate uremic toxins phosphate binder short chain fatty acid PTH |
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