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HERO ID
8561827
Reference Type
Journal Article
Subtype
Review
Title
Phosphate, Microbiota and CKD
Author(s)
Favero, C; Carriazo, S; Cuarental, L; Fernandez-Prado, R; Gomá-Garcés, E; Perez-Gomez, MV; Ortiz, A; Fernandez-Fernandez, B; Sanchez-Niño, MD
Year
2021
Is Peer Reviewed?
1
Journal
Nutrients
ISSN:
2072-6643
Volume
13
Issue
4
Language
English
PMID
33924419
DOI
10.3390/nu13041273
Abstract
Phosphate is a key uremic toxin associated with adverse outcomes. As chronic kidney disease (CKD) progresses, the kidney capacity to excrete excess dietary phosphate decreases, triggering compensatory endocrine responses that drive CKD-mineral and bone disorder (CKD-MBD). Eventually, hyperphosphatemia develops, and low phosphate diet and phosphate binders are prescribed. Recent data have identified a potential role of the gut microbiota in mineral bone disorders. Thus, parathyroid hormone (PTH) only caused bone loss in mice whose microbiota was enriched in the Th17 cell-inducing taxa segmented filamentous bacteria. Furthermore, the microbiota was required for PTH to stimulate bone formation and increase bone mass, and this was dependent on bacterial production of the short-chain fatty acid butyrate. We review current knowledge on the relationship between phosphate, microbiota and CKD-MBD. Topics include microbial bioactive compounds of special interest in CKD, the impact of dietary phosphate and phosphate binders on the gut microbiota, the modulation of CKD-MBD by the microbiota and the potential therapeutic use of microbiota to treat CKD-MBD through the clinical translation of concepts from other fields of science such as the optimization of phosphorus utilization and the use of phosphate-accumulating organisms.
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