The Kidney–Gut–Muscle Axis in End-Stage Renal Disease is Similarly Represented in Older Adults

• Main Author: Michael S. Lustgarten
• Format: Article
• Language: English
• Published: MDPI AG 2019-12-01
• Series: Nutrients
• Subjects: esrd; gut microbiome-derived uremic metabolites; aging; renal function; sarcopenia; muscle composition
• Online Access: https://www.mdpi.com/2072-6643/12/1/106

Decreased renal function, elevated circulating levels of urea, intestinal levels of urea-degrading bacteria, and gut-derived uremic metabolites are present in end-stage renal disease (ESRD), a cohort that has reduced muscle mass and physical function, and poor muscle composition. This phenotype, defined as the kidney−gut−muscle axis, is similarly represented in older adults that do not have ESRD. The purpose of this short communication is to illuminate these findings, and to propose a strategy that can positively impact the kidney−gut−muscle axis. For example, dietary fiber is fermented by intestinal bacteria, thereby producing the short-chain fatty acids (SCFAs) acetate, propionate, and butyrate, which affect each component of the kidney−gut−muscle axis. Accordingly, a high-fiber diet may be an important approach for improving the kidney−gut−muscle axis in ESRD and in older adults that do not have ESRD.