The role of the gut–kidney axis in the progression of chronic kidney disease

The gut microbiota is a collection of diverse microorganisms inhabiting the human gastrointestinal tract. This vast ecosystem comprises trillions of coexisting, symbiotic, and even opportunistically pathogenic microorganisms, whose abundance, composition, and activity are constantly changing. Recent research has revealed a close association between the gut microbiota and kidney diseases, leading to the formation of the “gut–kidney axis” concept. This area of research is actively evolving, generating new hypotheses and theories. Consequently, there is a need to systematize current knowledge regarding the mechanisms of the gut–kidney axis and the alterations in the gut microbial community in chronic kidney disease. This review covers the results of scientific publications from leading databases such as PubMed, eLibrary.Ru, MEDLINE, PubMed Central, and Google Scholar, from 1995 to March 2026, that focus on the interaction between the gut microbiota and chronic kidney disease. In addition to wellestablished factors affecting gut–kidney axis homeostasis, such as shortchain fatty acids and uremic toxins, emerging evidence points to the role of the protein corisin and the influence of the microbiota on the regulation of ferroptosis. Changes in the composition of individual gut microbiota members at different taxonomic levels may correlate with their involvement in specific metabolic processes and exert either beneficial or detrimental effects on the host–microbiota relationship. Progress has been made in identifying potential microbial biomarkers of kidney injury and in developing therapeutic strategies aimed at modulating the gut–kidney axis to slow the progression of chronic kidney disease.