Chronic kidney disease has been associated with changes in the function and composition of the gut microbiota. The ecosystem of the human gut consists of trillions of microorganisms forming an authentic metabolically active organ that is fueled by nutrients to produce bioactive compounds. These microbiota-derived metabolites may be protective for kidney function (e.g., short-chain fatty acids from fermentation of dietary fibers) or deleterious (e.g., gut-derived uremic toxins such as trimethylamine N-oxide, p-cresyl sulfate, and indoxyl sulfate from fermentation of amino acids). Although diet is the cornerstone of the management of the patient with chronic kidney disease, it remains a relatively underused component of the clinician’s armamentarium. In this review, we describe the latest advances in understanding the diet-microbiota crosstalk in the uremic context and how this communication might contribute to chronic kidney disease progression and complications. We then discuss how this knowledge could be harnessed for personalized nutrition strategies to prevent patients with chronic kidney disease progressing to kidney failure and its detrimental consequences.

慢性肾病 与肠道菌群功能和组成的变化有关。人体肠道的生态系统由数以万亿计的微生物组成，这些微生物形成了一个真正的代谢活跃的器官，由营养物质驱动，产生生物活性化合物。这些微生物群衍生的代谢物可能对肾功能有保护作用（例如，来自膳食纤维发酵的短链脂肪酸）或有害的（例如，肠道衍生的尿毒症毒素，例如三甲胺N-氧化物，p-甲酚硫酸盐和来自氨基酸发酵的硫酸吲哚酚）。尽管饮食是慢性肾病患者管理的基石，但它仍然是临床医生设备中相对未充分利用的组成部分。在这篇综述中，我们描述了了解尿毒症背景下饮食-微生物群串扰的最新进展，以及这种交流如何导致慢性肾病进展和并发症。然后，我们讨论如何利用这些知识制定个性化的营养策略，以防止慢性肾病患者进展为 肾衰竭 及其不利后果。