Figure 7.

Gut microbiome - host interaction promotes chronic inflammation in children with CKD. Pediatric patients with CKD stage dependently develop a leaky gut barrier and systemic imbalance of microbiome-derived metabolites. Patients with CKD exhibit a reduction in SCFA and an increase of indole metabolites of bacterial origin due to alterations of the taxonomic composition of the gut microbiome and nutritional alterations. These changes are associated with increased serum TNF-α levels, AhR-dependent secretion of TNF-α from monocytes, and a shift from classic to intermediate and nonclassic monocytes. Additionally, patients with CKD show a dysregulation of MAIT and Treg cell subsets. KT leads to a partial normalization of these dysregulated features.