{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:01:08Z","timestamp":1785326468999,"version":"3.55.0"},"reference-count":92,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Patients with kidney disease often exhibit pathological alterations such as gut dysbiosis, accumulation of uremic toxins, and systemic inflammation. In recent years, microecological agents\u2014represented by pre-biotics, probiotics, and synbiotics\u2014have emerged as a novel strategy targeting the \u201cgut-kidney axis.\u201d These agents act through mechanisms including modulation of gut microbiota balance, improvement of intestinal barrier function, reduction of endotoxin levels, and anti-inflammatory as well as antioxidant effects. Our review of the available evidence on microecological agents across various kidney diseases reveals that these interventions can delay the progression of renal function decline in patients with Chronic Kidney Disease (CKD) by restoring gut microbiota balance and reducing the systemic burden of uremic toxins and other harmful metabolites. Concurrently, they help mitigate CKD-related complications, including mineral and bone disorders, cardiovascular and cerebrovascular events, and hyperuricemia. Moreover, microecological agents have demonstrated beneficial effects in attenuating renal injury in acute kidney injury (AKI), reducing the incidence of nephrolithiasis, and exerting a modulatory role in lupus nephritis (LN). However, existing evidence remains unevenly distributed, and conclusions regarding efficacy vary due to differences in the type, dosage, and timing of microecological interventions, thus necessitating a systematic review. This article synthesizes current research on microecological agents across various kidney diseases, systematically evaluates their clinical efficacy and heterogeneity, and discusses future development strategies and translational potential.<\/jats:p>","DOI":"10.3389\/fmed.2026.1815214","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:10:50Z","timestamp":1785323450000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic potential and research progress of microecological agents in kidney diseases"],"prefix":"10.3389","volume":"13","author":[{"given":"Yixiang","family":"Qian","sequence":"first","affiliation":[{"name":"Department of Nephrology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, China"]},{"name":"Department of Nephrology, The Second People's Hospital","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1058238","DOI":"10.3389\/fnut.2022.1058238","article-title":"Association between probiotic, prebiotic, and yogurt consumption and chronic kidney disease: the NHANES 2010-2020","volume":"9","author":"Liu","year":"2022","journal-title":"Front Nutr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"829349","DOI":"10.3389\/fmed.2022.829349","article-title":"Gut dysbiosis and kidney diseases","volume":"9","author":"Cao","year":"2022","journal-title":"Front Med (Lausanne)."},{"key":"B3","doi-asserted-by":"publisher","first-page":"352","DOI":"10.3390\/toxins13040252","article-title":"The impact of CKD on uremic toxins and gut microbiota","volume":"13","author":"Rysz","year":"2021","journal-title":"Toxins (Basel"},{"key":"B4","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3390\/microorganisms7010014","article-title":"What is the healthy gut microbiota composition? a changing ecosystem across age, environment, diet, and diseases","volume":"7","author":"Rinninella","year":"2019","journal-title":"Microorganisms"},{"key":"B5","doi-asserted-by":"publisher","first-page":"3841","DOI":"10.1128\/AEM.68.8.3841-3847.2002","article-title":"Oxalobacter formigenes and its potential role in human health","volume":"68","author":"Duncan","year":"2002","journal-title":"Appl Environ Microbiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1093\/jn\/137.3.751S","article-title":"Metabolic diversity of the intestinal microbiota: implications for health and disease","volume":"137","author":"Blaut","year":"2007","journal-title":"J. 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