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The Role of Gut Dysbiosis in the Bone–Vascular Axis in Chronic Kidney Disease

Laboratory of Nephrology, Department of Immunology and Microbiology, KU Leuven—University of Leuven, B-3000 Leuven, Belgium
Department of Nephrology and Renal Transplantation, University Hospitals Leuven, B-3000 Leuven, Belgium
Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven—University of Leuven, B-3000 Leuven, Belgium
Author to whom correspondence should be addressed.
Toxins 2020, 12(5), 285;
Received: 30 March 2020 / Revised: 15 April 2020 / Accepted: 16 April 2020 / Published: 29 April 2020
(This article belongs to the Special Issue Comorbidities in Chronic Kidney Disease (CKD))
Patients with chronic kidney disease (CKD) are at increased risk of bone mineral density loss and vascular calcification. Bone demineralization and vascular mineralization often concur in CKD, similar to what observed in the general population. This contradictory association is commonly referred to as the ‘calcification paradox’ or the bone–vascular axis. Mounting evidence indicates that CKD-associated gut dysbiosis may be involved in the pathogenesis of the bone–vascular axis. A disrupted intestinal barrier function, a metabolic shift from a predominant saccharolytic to a proteolytic fermentation pattern, and a decreased generation of vitamin K may, alone or in concert, drive a vascular and skeletal pathobiology in CKD patients. A better understanding of the role of gut dysbiosis in the bone–vascular axis may open avenues for novel therapeutics, including nutriceuticals. View Full-Text
Keywords: bone; vascular calcification; gut; CKD bone; vascular calcification; gut; CKD
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Evenepoel, P.; Dejongh, S.; Verbeke, K.; Meijers, B. The Role of Gut Dysbiosis in the Bone–Vascular Axis in Chronic Kidney Disease. Toxins 2020, 12, 285.

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