Alteraciones en el eje intestino-riñón durante la enfermedad renal crónica: causas, consecuencias y propuestas de tratamiento

Ivan Armando Osuna-Padilla, Gabriela Leal Escobar

Resumen


La enfermedad renal crónica y el estado urémico se asocian con alteraciones en la permeabilidad intestinal y cambios en la microbiota intestinal, provocando una mayor producción y translocación de toxinas urémicas como sulfato de indoxilo (IS) y sulfato de p-cresilo (pCS), detonando una respuesta inflamatoria. El estado inflamatorio y el incremento en concentraciones séricas de IS y pCS se han asociado con una mayor mortalidad, mayor número de eventos cardiovasculares y mayores alteraciones en el metabolismo mineral y óseo. Se han estudiado diversas estrategias nutricionales y farmacológicas para modular la microbiota intestinal y mejorar las alteraciones en la permeabilidad intestinal, entre ellas la suplementación con probióticos, prebióticos y simbióticos, modificaciones en la composición de la dieta y uso de agentes adsorbentes. El objetivo del presente trabajo es realizar una revisión de las causas de las alteraciones intestinales y de la microbiota intestinal en el paciente con enfermedad renal crónica, analizando las consecuencias de dichos cambios y las intervenciones estudiadas hasta la actualidad.


Palabras clave


Insuficiencia renal crónica; Microbioma gastrointestinal; Uremia; Probióticos; Prebióticos; Terapia dietética

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Referencias


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DOI: http://dx.doi.org/10.14306/renhyd.21.2.244

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Copyright (c) 2017 Iván Armando Osuna Padilla

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