Fig. 2.

The relationship of gut dysbiosis and chronic kidney disease stages. Left: Vicious circuit that theoretically impact in health status of kidney. Kidney failure cause an increase in blood urea levels, then urea influxes to gut lumen and alters gut microbiota (dysbiosis), this condition increases uremic toxins and NH4OH and these toxins damage to gut epithelial tight junction which increases permeability of gut barrier and then uremic toxins and bacterial derivatives such as endotoxins translocate to blood circulation and damage to organs such as heart and kidney. Right: The stages of chronic kidney disease according to GFR. CKD: Chronic kidney disease; CVD: Cardiovascular disease; GFR: Glomerular filtration rate; ESRD: End stage renal disease.