Kronik Böbrek Yetmezliğinde Bağırsak Mikrobiyotası ve Endotoksemi

Yıl 2021, Cilt: 5 Sayı: 1, 37 - 46, 24.12.2021

Hacer Alataş , Mendane Saka

Öz

Gastrointestinal sistemdeki bakteri türü ve konsantrasyonu fetal hayattan yaşlılığa kadar birçok etkenin etkisiyle değişime uğramaktadır. Kronik böbrek yetmezliği (KBY) görülen bireylerde artan üremi, metabolik asidoz, verilen diyet kısıtlamaları, uygulanan tıbbi tedavilerin etkisi, kolonik geçiş zamanının uzaması gibi birçok neden intestinal mikrobiyota florasında ve fonksiyonunda değişmelere neden olmaktadır. Bu değişiklikler kolonun mikrobiyal protein fermantasyonunu değiştirmekte ve üremik toksinlerin oluşumunu arttırmaktadır. Bu toksik maddeler intestinal lümendeki sıkı bağlantı (tight junction) proteinlerine zarar vermekte ve bağırsağın koruyucu epitelyal bariyerini bozmaktadır. Sonuçta bağırsak kaynaklı üremik toksinler sistemik dolaşıma geçmekte KBY progresyonuna, kardiyovasküler hastalıklara (KVH), insülin direncine, inflamasyona ve protein-enerji malnütrisyonuna katkıda bulunmaktadır.

Anahtar Kelimeler

kronik böbrek yetmezliği, mikrobiyota, endotoksemi

Kaynakça

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