Contributory Role of Gut Microbiota and Their Metabolites Towards Cardiovascular Complications in Chronic Kidney Disease

Abstract

The gut microbiome has recently emerged as a novel risk factor that impacts health and disease. Our gut microbiota can function as an endocrine organ through its unique ability to metabolize various dietary precursors, and can fuel the systemic inflammation observed in chronic disease. This is especially important in the setting of chronic kidney disease, where microbial metabolism can directly contribute to accumulation of circulating toxins that can then alter and shift the balance of microbiota composition and downstream functions. To study this process, advances inomics technologies are providing opportunities to understand not only the taxonomy but also functional diversity of our microbiome. We can also reliably quantify en masse a wide range of uremic byproducts of microbial metabolism. Herein, we examine the bidirectional relationship between the gut microbiome and the failing kidneys. We will describe potential approaches targeting gut microbiota for cardiovascular risk reduction in chroinc kidney disease using an illustrative example of a novel gut-generated metabolite, trimethylamine N-oxide (TMAO).