The Gut Microbiome and The Metabolome in Chronic Kidney Disease

慢性肾脏疾病（CKD）可能会改变人类宿主与其自身之间的稳态关系。 肠道微生物居民（即，肠道微生物群），这是由于尿素向 肠道微生物群、饮食改变和小分子尿排泄减少 由肠道微生物群产生。因此，肠道微生物群的组成及其 代谢产物副产物可能在CKD患者中发生改变。我们提出了一套相互关联的具体 旨在研究CKD、肠道微生物群和粪便代谢组、血浆 代谢组学，以及使用纵向前瞻性队列的临床结果的发展， 慢性肾功能不全队列研究（CRIC）此外，我们还提出了一个小的干预措施， 一项在额外的CKD人群中根除肠道微生物群并重新填充的研究 患者，以确定肠道衍生的副产品，积累在体循环。的结果 我们的研究将为干预提供新的见解，例如调节饮食，这可能会改变 肠道微生物群的代谢组，以帮助预防和/或治疗与肠道微生物群相关的疾病。 CKD的发展。

Chronic kidney disease (CKD) may alter the homeostatic relationship between human hosts and their intestinal tract microbial inhabitants (i.e., the gut microbiota) due to the enhanced delivery of urea to the gut microbiota, alterations in diet, and the decrease in urinary excretion of small molecules produced by the gut microbiota. As a result, both the composition of the gut microbiota and its metabolite byproducts may be altered in patients with CKD. We propose a set of inter-related specific aims to examine the association between CKD, gut microbiota and the fecal metabolome, the plasma metabolome, and the development of clinical outcomes using a longitudinal prospective cohort within the Chronic Renal Insufficiency Cohort (CRIC) Study. In addition, we propose a small interventional study to eradicate and then re-populate the gut microbiota among an additional population of CKD patients to identify gut-derived byproducts that accumulate in the systemic circulation. The results of our study will provide new insights into interventions, such as modulation of diet, that may alter the metabolome of the gut microbiota to help prevent and/or treat diseases associated with the development of CKD.