Chronic Kidney Disease (CKD) is a worldwide public health problem associated with high morbidity, mortality, and socioeconomic burden. Despite recent advances in pathogenesis and effective Standard of Care (SOC) therapy, the incidence of end stage renal disease remains high, attributed to the complex and diverse pathophysiological pathways in progression of CKD. Among the many pathogenetic pathways, inflammation plays the most central role in disease progression and related complications. Current SOC treatment to slow CKD progression has not adequately addressed these complex processes as a result of persistence of low-grade inflammation occurring at all stages of CKD. Previous attempts to address the inflammatory pathway with specific anti-inflammatory agents were, in certain cases discontinued for reasons ranging from drug safety to efficacy concerns, and business development decisions. Recent research findings demonstrating direct correlation between systemic inflammation associated gut microbiota changes and CKD progression, provided a potential novel therapeutic approach to target the inflammatory pathways. Exploring current scientific knowledge of modulating gut microbiome with microbiome-based therapies provides options in addressing these complex pathogenetic mechanisms of CKD-induced inflammation.

The purpose of this minireview is to discuss the role of inflammation associated with gut microbiome changes in CKD progression and gut microbiome-based therapeutic options to slow CKD progression.