The relationship between dietary fiber, microbiota and kidney diseases in cats and dogs

Yıl 2024, Cilt: 8 Sayı: 1, 39 - 49, 30.04.2024

Refik Sevim Gülcan Demirel

https://doi.org/10.30704/http-www-jivs-net.1417586

Öz

Chronic kidney disease (CKD), which is an increasingly common disease in humans and a global health problem, is also a very common disease in cats and dogs. CKD can be caused by primary glomerulopathies, nephroliths, renal dysplasia, polycystic kidney disease, pyelonephritis, renal carcinomas, nephrotoxic drugs and toxins. The fact that cats diagnosed with CKD and with shorter survival time have low or excess body weights suggests that there may be strong correlations between diet and CKD. In recent years, effects of nutrition on microbiota changes and the role of these changes in diseases have taken particular interest in veterinary medicine. This review article focuses on the curative role of dietary fiber intake, which targets the intestinal microbiota and aims to reverse dysbiotic factors in cats and dogs with chronic kidney disease.

Anahtar Kelimeler

dietary fiber, prebiotics, renal diseases, microbiome

Kaynakça

• Alexander, C., Cross, T.-W. L., Devendran, S., Neumer, F., Theis, S., Ridlon, J. M., Suchodolski, J. S., de Godoy, M. R. C., & Swanson, K. S. (2018). Effects of prebiotic inulin-type fructans on blood metabolite and hormone concentrations and faecal microbiota and metabolites in overweight dogs. British Journal of Nutrition, 120(6), 711–720.
• Bartges, J. W. (2012). Chronic kidney disease in dogs and cats. Veterinary Clinics of North America: Small Animal Practice, 42(4), 669–692.
• Baye, K., Guyot, J. P., & Mouquet-Rivier, C. (2017). The unresolved role of dietary fibers on mineral absorption. Critical Reviews in Food Science and Nutrition, 57(5), 949–957.
• Biruete, A. (2017). Effects of inulin supplementation on markers of mineral and bone metabolism and the gut microbiota in hemodialysis patients. PhD thesis, University of f Illinois.
• Biruete, A., Chen, N. X., Srinivasan, S., O’Neill, K., Nelson, D., Hill Gallant, K. M., & Moe, S. M. (2023). The effects of dietary fiber based on fermentability and viscosity on phosphorus absorption and the gut microbiome in chronic kidney disease-mineral and bone disorder. Journal of Clinical and Translational Science, 7(s1), 132–132.
• Bosco, A. M., Pereira, P. P., Almeida, B. F. M., Narciso, L. G., dos Santos, D. B., Santos-Neto, Á. J. dos, Ferreira, W. L., & Ciarlini, P. C. (2016). Free p-Cresol Alters neutrophil function in dogs. Artificial Organs, 40(5), 480–488.
• Brownawell, A. M., Caers, W., Gibson, G. R., Kendall, C. W. C., Lewis, K. D., Ringel, Y., & Slavin, J. L. (2012). Prebiotics and the health benefits of fiber: Current regulatory status, future research, and goals. The Journal of Nutrition, 142(5), 962–974.
• Carvalho, L., Kelley, D., Labato, M. A., & Webster, C. R. (2021). Hyperammonemia in azotemic cats. Journal of Feline Medicine and Surgery, 23(8), 700–707.
• Celi, P., Cowieson, A. J., Fru-Nji, F., Steinert, R. E., Kluenter, A.-M., & Verlhac, V. (2017). Gastrointestinal functionality in animal nutrition and health: New opportunities for sustainable animal production. Animal Feed Science and Technology, 234, 88–100.
• Chacar, F. C., Kogika, M. M., Zafalon, R. V. A., & Brunetto, M. A. (2020). Vitamin D metabolism and its role in mineral and bone disorders in chronic kidney disease in humans, dogs and cats. Metabolites, 10(12), 499-510.
• Chen, H., Dunaevich, A., Apfelbaum, N., Kuzi, S., Mazaki‐Tovi, M., Aroch, I., & Segev, G. (2020). Acute on chronic kidney disease in cats: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome. Journal of Veterinary Internal Medicine, 34(4), 1496–1506.
• Crespo-Salgado, J., Vehaskari, V. M., Stewart, T., Ferris, M., Zhang, Q., Wang, G., Blanchard, E. E., Taylor, C. M., Kallash, M., Greenbaum, L. A., & Aviles, D. H. (2016). Intestinal microbiota in pediatric patients with end stage renal disease: A midwest pediatric nephrology consortium study. Microbiome, 4(1), 50.
• David, L. A., Maurice, C. F., Carmody, R. N., Gootenberg, D. B., Button, J. E., Wolfe, B. E., Ling, A. V., Devlin, A. S., Varma, Y., Fischbach, M. A., Biddinger, S. B., Dutton, R. J., & Turnbaugh, P. J. (2014). Diet rapidly and reproducibly alters the human gut microbiome. Nature, 505(7484), 559–563.
• De Loor, J., Daminet, S., Smets, P., Maddens, B., & Meyer, E. (2013). Urinary biomarkers for acute kidney injury in dogs. Journal of Veterinary Internal Medicine, 27(5), 998–1010.
• Desai, M. S., Seekatz, A. M., Koropatkin, N. M., Kamada, N., Hickey, C. A., Wolter, M., Pudlo, N. A., Kitamoto, S., Terrapon, N., Muller, A., Young, V. B., Henrissat, B., Wilmes, P., Stappenbeck, T. S., Núñez, G., & Martens, E. C. (2016). A dietary fiber-deprived gut microbiota degrades the colonic mucus barrier and enhances pathogen susceptibility. Cell, 167(5), 1339-1353.
• Di Iorio, B., Di Micco, L., Marzocco, S., De Simone, E., De Blasio, A., Sirico, M., & Nardone, L. (2017). Very low-protein diet (VLPD) reduces metabolic acidosis in subjects with chronic kidney disease: The “nutritional light signal” of the renal acid load. Nutrients, 9(1), 69.
• Dou, L., Jourde-Chiche, N., Faure, V., Cerini, C., Berland, Y., Dignat-George, F., & Brunet, P. (2007). The uremic solute indoxyl sulfate induces oxidative stress in endothelial cells. Journal of Thrombosis and Haemostasis, 5(6), 1302–1308.
• Enomoto, A., Takeda, M., Tojo, A., Sekine, T., Cha, S. H., Khamdang, S., Takayama, F., Aoyama, I., Nakamura, S., Endou, H., & Niwa, T. (2002). Role of organic anion transporters in the tubular transport of indoxyl sulfate and the induction of its nephrotoxicity. Journal of the American Society of Nephrology, 13(7), 1711–1720.
• Ephraim, E., & Jewell, D. E. (2020). Effect of added dietary betaine and soluble fiber on metabolites and fecal microbiome in dogs with early renal disease. Metabolites 10(9), 370.
• Fahey, G. C., Novotny, L., Layton, B., & Mertens, D. R. (2019). Critical factors in determining fiber content of feeds and foods and their ingredients. Journal of aoac internatıonal, 102(1), 52–62.
• Favero, C., Carriazo, S., Cuarental, L., Fernandez-Prado, R., Gomá-Garcés, E., Perez-Gomez, M. V., Ortiz, A., Fernandez-Fernandez, B., & Sanchez-Niño, M. D. (2021). Phosphate, microbiota and CKD. Nutrients, 13(4), 1273.
• Freeman, L. M., Lachaud, M. P., Matthews, S., Rhodes, L., & Zollers, B. (2016). Evaluation of weight loss over time in cats with chronic kidney disease. Journal of Veterinary Internal Medicine, 30(5), 1661–1666.
• Furuse, S. U., Ohse, T., Jo-Watanabe, A., Shigehisa, A., Kawakami, K., Matsuki, T., Chonan, O., & Nangaku, M. (2014). Galacto-oligosaccharides attenuate renal injury with microbiota modification. Physiological Reports, 2(7), e12029.
• Garcia-Mazcorro, J. F., Barcenas-Walls, J. R., Suchodolski, J. S., & Steiner, J. M. (2017). Molecular assessment of the fecal microbiota in healthy cats and dogs before and during supplementation with fructo-oligosaccharides (FOS) and inulin using high-throughput 454-pyrosequencing. PeerJ, 5, e3184.
• Hall, J. A., Jackson, M. I., Jewell, D. E., & Ephraim, E. (2020). Chronic kidney disease in cats alters response of the plasma metabolome and fecal microbiome to dietary fiber. PlosOne, 15(7), e0235480.
• Hall, J. A., MacLeay, J., Yerramilli, M., Obare, E., Yerramilli, M., Schiefelbein, H., Paetau-Robinson, I., & Jewell, D. E. (2016). Positive impact of nutritional interventions on serum symmetric dimethylarginine and creatinine concentrations in client-owned geriatric dogs. PlosOne, 11(4), e0153653.
• Handl, S., Dowd, S. E., Garcia-Mazcorro, J. F., Steiner, J. M., & Suchodolski, J. S. (2011). Massive parallel 16S rRNA gene pyrosequencing reveals highly diverse fecal bacterial and fungal communities in healthy dogs and cats. FEMS Microbiology Ecology, 76(2), 301–310.
• Hasegawa, S., Jao, T. M., & Inagi, R. (2017). Dietary metabolites and chronic kidney disease. Nutrients, 9(4), 358.
• Hipsley, E. H. (1953). Dietary “fibre” and pregnancy toxaemia. British Medical Journal, 2(4833), 420–422.
• Hoffmann, A. R., Proctor, L. M., Surette, M. G., & Suchodolski, J. S. (2016). The microbiome: the trillions of microorganisms that maintain health and cause disease in humans and companion animals. Veterinary Pathology, 53(1), 10-21.
• Hoibian, E., Florens, N., Koppe, L., Vidal, H., & Soulage, C. O. (2018). Distal colon motor dysfunction in mice with chronic kidney disease: Putative role of uremic toxins. Toxins, 10(5), 204.
• Hua, S., Lv, B., Qiu, Z., Li, Z., Wang, Z., Chen, Y., Han, Y., Tucker, K. L., Wu, H., & Jin, W. (2023). Microbial metabolites in chronic heart failure and its common comorbidities. EMBO Molecular Medicine, 15(6), e16928.
• Ide, K., Shinohara, M., Yamagishi, S., Endo, A., Nishifuji, K., & Tochio, T. (2020). Kestose supplementation exerts bifidogenic effect within fecal microbiota and increases fecal butyrate concentration in dogs. Journal of Veterinary Medical Science, 82(1), 1–8.
• Jazani, N. H., Savoj, J., Lustgarten, M., Lau, W. L., & Vaziri, N. D. (2019). Impact of gut dysbiosis on neurohormonal pathways in chronic kidney disease. Diseases, 7(1), 21.
• Johnston, K., Lamport, A., & Batt, R. (1993). An unexpected bacterial flora in the proximal small intestine of normal cats. Veterinary Record, 132(14), 362–363.
• Jones, S. E., Quimby, J. M., Summers, S. C., Adams, S. M., Caney, S. M., & Rudinsky, A. J. (2022). Survey of defecation habits in apparently healthy and chronic kidney disease cats. Journal of Feline Medicine and Surgery, 24(2), 131–141.
• Kafeshani, M. (2017). The gut microbiome, diet, and chronic kidney disease. Review Journal of Preventive Epidemiology, 2(1), e05.
• Karbach, S. H., Schönfelder, T., Brandão, I., Wilms, E., Hörmann, N., Jäckel, S., Schüler, R., Finger, S., Knorr, M., Lagrange, J., Brandt, M., Waisman, A., Kossmann, S., Schäfer, K., Münzel, T., Reinhardt, C., & Wenzel, P. (2016). Gut microbiota promote angiotensin II–induced arterial hypertension and vascular dysfunction. Journal of the American Heart Association, 5(9), e003698.
• Kawabata, C., Hirakawa, Y., Inagi, R., & Nangaku, M. (2023). Acetate attenuates kidney fibrosis in an oxidative stress‐dependent manner. Physiological Reports, 11(14), e15774.
• Kerl, M. E., & Cook, C. R. (2005). Glomerular filtration rate and renal scintigraphy. Clinical Techniques in Small Animal Practice, 20(1), 31–38.
• Kieffer, D. A., Piccolo, B. D., Vaziri, N. D., Liu, S., Lau, W. L., Khazaeli, M., Nazertehrani, S., Moore, M. E., Marco, M. L., Martin, R. J., & Adams, S. H. (2016). Resistant starch alters gut microbiome and metabolomic profiles concurrent with amelioration of chronic kidney disease in rats. American Journal of Physiology-Renal Physiology, 310(9), F857–F871.
• Kiuchi, M. G., Ho, J. K., Nolde, J. M., Gavidia, L. M. L., Carnagarin, R., Matthews, V. B., & Schlaich, M. P. (2020). Sympathetic activation in hypertensive chronic kidney disease – A stimulus for cardiac arrhythmias and sudden cardiac death? Frontiers in Physiology, 10, 1546.
• Kwon, Y. J., Lee, H. S., Park, G. E., & Lee, J. W. (2022). Association between dietary fiber intake and all-cause and cardiovascular mortality in middle aged and elderly adults with chronic kidney disease. Frontiers in Nutrition, 9, 863391.
• Lau, W. L., Kalantar-Zadeh, K., & Vaziri, N. D. (2015). The Gut as a source of inflammation in chronic kidney disease. Nephron, 130(2), 92–98.
• Lawson, J. S., & Jepson, R. E. (2021). Feline comorbidities: The intermingled relationship between chronic kidney disease and hypertension. Journal of Feline Medicine and Surgery, 23(9), 812–822.
• Li, J., Zhao, F., Wang, Y., Chen, J., Tao, J., Tian, G., Wu, S., Liu, W., Cui, Q., Geng, B., Zhang, W., Weldon, R., Auguste, K., Yang, L., Liu, X., Chen, L., Yang, X., Zhu, B., & Cai, J. (2017). Gut microbiota dysbiosis contributes to the development of hypertension. Microbiome, 5(1), 14.
• Liang, S. K., Wang, J. Q., & Han, B. (2024). Effects of inulin on fecal microbiota and specific immunity in cats. Research in Veterinary Science, 172, 105252.
• Liao, Y., Chou, C., & Lee, Y. (2019). The association of indoxyl sulfate with fibroblast growth factor‐23 in cats with chronic kidney disease. Journal of Veterinary Internal Medicine, 33(2), 686–693.
• Liu, X.-Y., Li, J., Zhang, Y., Fan, L., Xia, Y., Wu, Y., Chen, J., Zhao, X., Gao, Q., Xu, B., Nie, C., Li, Z., Tong, A., Wang, W., & Cai, J. (2022). Kidney microbiota dysbiosis contributes to the development of hypertension. Gut Microbes, 14(1), 104-115.
• Lopez, H. W., Coudray, C., Levrat-Verny, M. A., Feillet-Coudray, C., Demigné, C., & Rémésy, C. (2000). Fructooligosaccharides enhance mineral apparent absorption and counteract the deleterious effects of phytic acid on mineral homeostasis in rats. Journal of Nutritional Biochemistry, 11(10), 500–508.
• Lund, E. M., Armstrong, P. J., Kirk, C. A., Kolar, L. M., & Klausner, J. S. (1999). Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. Journal of the American Veterinary Medical Association, 214(9), 1336–1341.
• Machado, D. P., Ruberti, B., Teixeira, F. A., Vendramini, T. H. A., Pfrimer, K., Chacar, F. C., Balieiro, J. C. C., Pontieri, C. F. F., & Brunetto, M. A. (2022). Body composition of healthy cats and cats with chronic kidney disease fed on a dry diet low in phosphorus with maintenance protein. Toxins, 14(12), 865.
• Mafra, D., & Fouque, D. (2015). Gut microbiota and inflammation in chronic kidney disease patients. Clinical Kidney Journal, 8(3), 332–334.
• Massot-Cladera, M., Azagra-Boronat, I., Franch, À., Castell, M., Rodríguez-Lagunas, M. J., & Pérez-Cano, F. J. (2020). Gut health-promoting benefits of a dietary supplement of vitamins with inulin and acacia fibers in rats. Nutrients, 12(8), 2196.
• Menon, V., Kopple, J. D., Wang, X., Beck, G. J., Collins, A. J., Kusek, J. W., Greene, T., Levey, A. S., & Sarnak, M. J. (2009). Effect of a very low-protein diet on outcomes: Long-term follow-up of the modification of diet in renal disease (MDRD) Study. American Journal of Kidney Diseases, 53(2), 208–217.
• Metzler, B. U., & Mosenthin, R. (2008). A Review of Interactions between dietary fiber and the gastrointestinal microbiota and their consequences on intestinal phosphorus metabolism in growing pigs. Asian-Australasian Journal of Animal Sciences, 21(4), 603–615.
• Middelbos, I. S., Vester Boler, B. M., Qu, A., White, B. A., Swanson, K. S., & Fahey, G. C. (2010). Phylogenetic characterization of fecal microbial communities of dogs fed diets with or without Supplemental dietary fiber using 454 Pyrosequencing. PlosOne, 5(3), e9768.
• Moghadamrad, S., McCoy, K. D., Geuking, M. B., Sägesser, H., Kirundi, J., Macpherson, A. J., & De Gottardi, A. (2015). Attenuated portal hypertension in germ‐free mice: Function of bacterial flora on the development of mesenteric lymphatic and blood vessels. Hepatology, 61(5), 1685-1695.
• Montemurno, E., Cosola, C., Dalfino, G., Daidone, G., De Angelis, M., Gobbetti, M., & Gesualdo, L. (2014). What would you like to eat, Mr CKD Microbiota? A mediterranean diet, please! Kidney and Blood Pressure Research, 39(2–3), 114–123.
• Nakabayashi, I., Nakamura, M., Kawakami, K., Ohta, T., Kato, I., Uchida, K., & Yoshida, M. (2011). Effects of synbiotic treatment on serum level of p-cresol in haemodialysis patients: a preliminary study. Nephrology Dialysis Transplantation, 26(3), 1094–1098.
• Nealon, N. J., Summers, S., Quimby, J., & Winston, J. A. (2024). Untargeted metabolomic profiling of serum from client-owned cats with early and late-stage chronic kidney disease. Scientific reports, 14(1), 4755.
• Nicholson, J. K., Holmes, E., Kinross, J., Burcelin, R., Gibson, G., Jia, W., & Pettersson, S. (2012). Host-Gut Microbiota Metabolic Interactions. Science, 336(6086), 1262–1267.
• Niwa, T. (2010). Indoxyl Sulfate Is a Nephro-Vascular Toxin. Journal of Renal Nutrition, 20(5), S2–S6. O’Neill, D. G., Church, D. B., McGreevy, P. D., Thomson, P. C., & Brodbelt, D. C. (2015). Longevity and mortality of cats attending primary care veterinary practices in England. Journal of Feline Medicine and Surgery, 17(2), 125–133.
• Patra, A. K. (2011). Responses of feeding prebiotics on nutrient digestibility, faecal microbiota composition and short-chain fatty acid concentrations in dogs: a meta-analysis. Animal, 5(11), 1743–1750.
• Pelaseyed, T., Bergström, J. H., Gustafsson, J. K., Ermund, A., Birchenough, G. M. H., Schütte, A., van der Post, S., Svensson, F., Rodríguez‐Piñeiro, A. M., Nyström, E. E. L., Wising, C., Johansson, M. E. V., & Hansson, G. C. (2014). The mucus and mucins of the goblet cells and enterocytes provide the first defense line of the gastrointestinal tract and interact with the immune system. Immunological Reviews, 260(1), 8–20.
• Perini, M. P., Pedrinelli, V., Marchi, P. H., Henríquez, L. B. F., Zafalon, R. V. A., Vendramini, T. H. A., Balieiro, J. C. de C., & Brunetto, M. A. (2023). Potential effects of prebiotics on gastrointestinal and immunological modulation in the feeding of healthy dogs: A review. Fermentation, 9(7), 693.
• Pietzner, M., Stewart, I. D., Raffler, J., Khaw, K.-T., Michelotti, G. A., Kastenmüller, G., Wareham, N. J., & Langenberg, C. (2021). Plasma metabolites to profile pathways in noncommunicable disease multimorbidity. Nature Medicine, 27(3), 471–479.
• Pilla, R., & Suchodolski, J. S. (2021). The Gut Microbiome of dogs and cats, and the influence of diet. Veterinary Clinics of North America: Small Animal Practice, 51(3), 605–621.
• Pinna, C., Vecchiato, C. G., Bolduan, C., Grandi, M., Stefanelli, C., Windisch, W., Zaghini, G., & Biagi, G. (2018). Influence of dietary protein and fructooligosaccharides on fecal fermentative end-products, fecal bacterial populations and apparent total tract digestibility in dogs. BMC Veterinary Research, 14(1), 106.
• Prajapati, A. S., Panchasara, H. H., Sutaria, P. T., Chauhan, P. M., & Suthar, A. N. (2023). Diagnosis of Chronic renal failure in canine using enteric dialysis. In Advanced Research in Biological Science, 4, 111–124.
• Ranganathan, N. (2018). “Enteric Dialysis®” – From Concept to Reality [In conjunction with standard care of therapy]. https://divcomplatform.s3.amazonaws.com/www.integrativepractitioner.com/images/24ed6d074968fed04d45051d62779bdf.pdf
• Reynolds, B. S., & Lefebvre, H. P. (2013). Feline CKD: Pathophysiology and risk factors — what do we know? Journal of Feline Medicine and Surgery, 15(1_suppl), 3–14.
• Rideout, T. C., & Fan, M. Z. (2004). Nutrient utilisation in response to dietary supplementation of chicory inulin in growing pigs. Journal of the Science of Food and Agriculture, 84(9), 1005–1012.
• Roberfroid, M. B. (2005). Introducing inulin-type fructans. British Journal of Nutrition, 93(S1), S13–S25.
• Samuel, B. S., Shaito, A., Motoike, T., Rey, F. E., Backhed, F., Manchester, J. K., Hammer, R. E., Williams, S. C., Crowley, J., Yanagisawa, M., & Gordon, J. I. (2008). Effects of the gut microbiota on host adiposity are modulated by the short-chain fatty-acid binding G protein-coupled receptor, Gpr41. Proceedings of the National Academy of Sciences, 105(43), 16767–16772.
• Shah, N. B., Allegretti, A. S., Nigwekar, S. U., Kalim, S., Zhao, S., Lelouvier, B., Servant, F., Serena, G., Thadhani, R. I., Raj, D. S., & Fasano, A. (2019). Blood Microbiome Profile in CKD. Clinical Journal of the American Society of Nephrology, 14(5), 692–701.
• Simpson, J. M., Martineau, B., Jones, W. E., Ballam, J. M., & Mackie, R. I. (2002). Characterization of fecal bacterial populations in canines: Effects of age, breed and dietary fiber. Microbial Ecology, 44(2), 186–197. Smith, P. M., Howitt, M. R., Panikov, N., Michaud, M., Gallini, C. A., Bohlooly-Y, M., Glickman, J. N., & Garrett, W. S. (2013). The microbial metabolites, short-chain fatty acids, regulate colonic T reg cell homeostasis. Science, 341(6145), 569–573. Souza, C. M. M., Bastos, T. S., Kaelle, G. C. B., Bortolo, M., de Oliveira, S. G., & Félix, A. P. (2023). Fine cassava fibre utilization as a dietary fibre source for dogs: Effects on kibble characteristics, diet digestibility and palatability, faecal metabolites and microbiota. Journal of Animal Physiology and Animal Nutrition, 107(S1), 18–29.
• Stuivenberg, G. A., Chmiel, J. A., Akouris, P. P., White, J., Wilcox, H., Seney, S., Burton, J. P., & Reid, G. (2023). Supplementing yogurt with probiotic Bifidobacteria to counter chronic kidney disease. Fermentation, 9(4), 391. Suchodolski, J. S. (2011). Intestinal Microbiota of Dogs and Cats: a Bigger World than We Thought. Veterinary Clinics of North America: Small Animal Practice, 41(2), 261–272. Suchodolski, J. S. (2016). Diagnosis and interpretation of intestinal dysbiosis in dogs and cats. The Veterinary Journal, 215, 30–37. Suchodolski, J. S. (2022). Analysis of the gut microbiome in dogs and cats. Veterinary Clinical Pathology, 50(S1), 6–17. Summers, S. C., Quimby, J. M., Isaiah, A., Suchodolski, J. S., Lunghofer, P. J., & Gustafson, D. L. (2019). The fecal microbiome and serum concentrations of indoxyl sulfate and p‐cresol sulfate in cats with chronic kidney disease. Journal of Veterinary Internal Medicine, 33(2), 662–669.
• Summers, S., Quimby, J., Gagné, J., & Lappin, M. (2023). The effect of dietary protein concentration on the fecal microbiome and serum concentrations of gut-derived uremic toxins in healthy adult cats. Veterinary Sciences, 10(8), 497.
• Summers, S., Quimby, J. M., Phillips, R. K., Stockman, J., Isaiah, A., Lidbury, J. A., Steiner, J. M., & Suchodolski, J. (2020). Preliminary evaluation of fecal fatty acid concentrations in cats with chronic kidney disease and correlation with indoxyl sulfate and p‐cresol sulfate. Journal of Veterinary Internal Medicine, 34(1), 206–215.
• Turroni, F., van Sinderen, D., & Ventura, M. (2011). Genomics and ecological overview of the genus Bifidobacterium. International Journal of Food Microbiology, 149(1), 37–44.
• Varley, P. F., McCarney, C., Callan, J. J., & O’Doherty, J. V. (2010). Effect of dietary mineral level and inulin inclusion on phosphorus, calcium and nitrogen utilisation, intestinal microflora and bone development. Journal of the Science of Food and Agriculture, 90(14), 2447–2454.
• Vaziri, N. D., Goshtasbi, N., Yuan, J., Jellbauer, S., Moradi, H., Raffatellu, M., & Kalantar-Zadeh, K. (2012). Uremic Plasma Impairs Barrier Function and Depletes the Tight Junction Protein Constituents of Intestinal Epithelium. American Journal of Nephrology, 36(5), 438–443.
• Vaziri, N. D., Yuan, J., Rahimi, A., Ni, Z., Said, H., & Subramanian, V. S. (2012). Disintegration of colonic epithelial tight junction in uremia: a likely cause of CKD-associated inflammation. Nephrology Dialysis Transplantation, 27(7), 2686–2693.
• Wang, X., Yang, S., Li, S., Zhao, L., Hao, Y., Qin, J., Zhang, L., Zhang, C., Bian, W., Zuo, L., Gao, X., Zhu, B., Lei, X. G., Gu, Z., Cui, W., Xu, X., Li, Z., Zhu, B., Li, Y., … Ren, F. (2020). Aberrant gut microbiota alters host metabolome and impacts renal failure in humans and rodents. Gut, 69(12), 2131–2142.
• Wilkins, L. J., Monga, M., & Miller, A. W. (2019). Defining dysbiosis for a cluster of chronic diseases. Scientific Reports, 9(1), 1–10.
• Wong, J. M. W., de Souza, R., Kendall, C. W. C., Emam, A., & Jenkins, D. J. A. (2006). Colonic Health: Fermentation and Short Chain Fatty Acids. Journal of Clinical Gastroenterology, 40(3), 235–243.
• Wu, I.-W., Hsu, K.-H., Lee, C.-C., Sun, C.-Y., Hsu, H.-J., Tsai, C.-J., Tzen, C.-Y., Wang, Y.-C., Lin, C.-Y., & Wu, M.-S. (2011). p-Cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. Nephrology Dialysis Transplantation, 26(3), 938–947.
• Yang, T., Richards, E. M., Pepine, C. J., & Raizada, M. K. (2018). The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease. Nature Reviews Nephrology, 14(7), 442–456.
• Younes, H., Garleb, K., Behr, S., Rémésy, C., & Demigné, C. (1995). Fermentable fibers or oligosaccharides reduce urinary nitrogen excretion by increasing urea disposal in the rat cecum. The Journal of Nutrition, 125(4), 1010–1016.