Evidence map›Paper›PMID 25967288›Full record

ReviewNephron2015

The Gut as a Source of Inflammation in Chronic Kidney Disease.

Wei Ling Lau, Kamyar Kalantar-Zadeh, Nosratola D Vaziri

Open access · bronzeAbstract readReview
In one paragraph

Review in Nephron, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 1 pooled it
21.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 1 synthesis or guideline pooled it, 451 citations in OpenAlex.

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77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Wei Ling LauDivision of Nephrology and Hypertension, University of California Irvine, Orange, Calif., USA.
Kamyar Kalantar-Zadeh
Nosratola D Vaziri
University of California, Irvine · US

Funding

University of California Health Participation in the National COVID Cohort Collaborative (N3C)UL1TR001414 · NCATS · UNIVERSITY OF CALIFORNIA-IRVINE · PI COOPER, DAN M, VILAIN, ERIC J. · 2015 to 2023
$35.1M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
NCATS NIH HHS UL1 TR001414NIDDK NIH HHS K24 DK091419NIDDK NIH HHS K24-DK091419
6 · The paper itself

Abstract

Chronic inflammation is a non-traditional risk factor for cardiovascular mortality in the chronic kidney disease (CKD) population. In recent years, the gastrointestinal tract has emerged as a major instigator of systemic inflammation in CKD. Postmortem studies previously discovered gut wall inflammation throughout the digestive tract in chronic dialysis patients. In CKD animals, colon wall inflammation is associated with breakdown of the epithelial tight junction barrier ('leaky gut') and translocation of bacterial DNA and endotoxin into the bloodstream. Gut bacterial DNA and endotoxin have also been detected in the serum from CKD and dialysis patients, whereby endotoxin levels increase with the CKD stage and correlate with the severity of systemic inflammation in the dialysis population. The CKD diet that is low in plant fiber and symbiotic organisms (in adherence with low potassium, low phosphorus intake) can alter the normal gut microbiome, leading to overgrowth of bacteria that produce uremic toxins such as cresyl and indoxyl molecules. The translocation of these toxins from the 'leaky gut' into the bloodstream further promotes systemic inflammation, adverse cardiovascular outcomes and CKD progression. Data are lacking on optimal fiber and yogurt consumption in CKD that would favor growth of a more symbiotic microbiome while avoiding potassium and phosphorus overload. Prebiotic and probiotic formulations have shown promise in small clinical trials, in terms of lowering serum levels of uremic toxins and improving quality of life. The evidence points to a strong relationship between intestinal inflammation and adverse outcomes in CKD, and more trials investigating gut-targeted therapeutics are needed.

Indexed as

Bacterial ToxinsBiological TransportGastrointestinal TractHumansInflammationKidney Failure, ChronicBacterial Toxins

Identifiers

PMID25967288
PMCPMC4485546
OpenAlexW2291733689

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.