Effects of Prebiotic Use on Disease Progression in Chronic Kidney Diseases

Öz

Chronic kidney disease (CKD) is a clinical syndrome characterized by progressive and irreversible loss of kidney function. While there exists a mutual and complex relationship between CKD and changes in the gut microbiota, both can influence each other. Various factors such as slowing of intestinal transit, repeated use of certain medications, dietary restrictions, and secretion of ammonia and urea into the intestine cause dysbiosis in CKD. Increased intestinal barrier permeability may facilitate the entry of uremic toxin precursors into the circulation. Increased uremic toxin levels may increase the risk of all-cause death and cardiovascular disease (CVD) in patients with mild-to-moderate CKD and chronic renal failure. Prebiotics are non-digestible food ingredients that increase the growth and activity of beneficial bacteria. Several studies have shown that prebiotics can modulate intestinal bacterial composition and also exert protective effects against kidney damage and dysfunction by reducing inflammation, oxidative stress and apoptosis. Therefore, prebiotics have emerged as a low-cost, health-beneficial and non-invasive treatment option for individuals with CKD. This review summarizes the effect of prebiotic use in chronic kidney disease on disease progression.

Anahtar Kelimeler

• Dysbiosis
• inflammation
• chronic kidney disease
• microbiota
• prebiotic

Kronik Böbrek Hastalıklarında Prebiyotik Kullanımının Hastalık Progresyonu Üzerine Etkileri

Öz

Kronik böbrek hastalığı (KBH), böbrek fonksiyonunun ilerleyici ve geri dönüşsüz kaybıyla karakterize bir klinik sendromdur. KBH ile bağırsak mikrobiyotasındaki değişiklikler arasında karşılıklı ve karmaşık bir ilişki bulunmakla birlikte her ikisi de birbirini etkileyebilmektedir. KBH’de intestinal geçişin yavaşlaması, belirli ilaçların tekrarlayan kullanımı, diyet kısıtlamaları, amonyak ve ürenin bağırsağa sekresyonu gibi çeşitli faktörler disbiyozise neden olmaktadır. Bağırsak bariyer geçirgenliğinin artması, üremik toksin öncülerinin dolaşıma girmesini kolaylaştırabilir. Artan üremik toksin seviyeleri, hafif-orta dereceli KBH ve kronik böbrek yetmezliği olan hastalarda tüm nedenlere bağlı ölüm ve kardiyovasküler hastalık (KVH) riskini artırabilir. Prebiyotikler, yararlı bakterilerin büyümesini ve aktivitesini artıran sindirilmeyen besin bileşenleridir. Yapılan birçok çalışma, prebiyotiklerin bağırsak bakteri kompozisyonunu modüle edebileceğini ve aynı zamanda inflamasyonu, oksidatif stresi ve apoptozu azaltarak böbrek hasarı ve işlev bozukluğuna karşı koruyucu etkiler gösterebileceğini öne sürmektedir. Bu nedenle prebiyotikler, KBH olan bireyler için düşük maliyetli, sağlık açısından faydalı ve invazif olmayan bir tedavi seçeneği olarak gündeme gelmiştir. Bu derlemede, KBH'de prebiyotik kullanımının hastalığın ilerlemesi üzerindeki etkileri özetlenmiştir.

Anahtar Kelimeler

• disbiyozis
• inflamasyon
• kronik böbrek hastalığı
• mikrobiyota
• prebiyotik

Kaynakça

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