The Contribution of Intestinal Barrier and Microbiome Ecosystem in Progression of Chronic Kidney Disease

Abstract Background The introduction of concepts such as “Intestinal renal syndrome” and “The gut-kidney axis” has opened the door to the study of gut microbiota and intestinal barrier integrity. Aim This study is to focus on these two keys which link the interaction between CKD and intestine. Material and Methods This study was carried out on 20 adult male albino rats initially weighing 180 - 193 grams that were divided into sham operated (control) and 5/6th nephrectomized rats. After 8 weeks, all rats were subjected to anthropometric studies, measurement of serum level of creatinine, urea, NGAL, indoxyl sulphate, urine volume, eGFR, aIb/Cr ratio and arterial blood pressure. Serum SCFA an indicator for microbiome disturbances and tissue occludine an indicator for intestinal barrier as well as histological study to the wall of colon were determined. Also, serum TNF α, MDA, glutathione peroxidase was measured as possible interactive mechanism. Results In the present study, nephrectomy group showed significant decrease in body weight and body mass index gain compared to control group. In addition, 5/6th nephrectomy showed significant increase in mean arterial blood pressure and the levels of serum creatinine, urea, NGAL, indoxyl sulphate, alb / cr ratio, malondialdehyde and TNF- α. While volume of urine, eGFR and level of serum GPx were significantly decreased. Moreover, with nephrectomy SCFA in serum and intestinal tissue level of occludine were significantly reduced and the histological studies showed decreased thickness of mucosa, reduced number of goblet cell and increased inflammatory cell infiltration. Conclusion CKD could be considered as one of the chronic stressors affecting gut microbiota production of SCFA and intestinal barrier integrity marker and histology through the induction of gut inflammation and oxidative stress. This study provides a theoretical basis for subsequent targeted treatment.