The Role of Gut Microbiota in Chronic Kidney Disease and Outcomes of Kidney Transplantation

The human gut microbial ecosystem comprises over 1000 species of bacteria and exhibits considerable interindividual variability at the species level. This complex microbial ecosystem in the human gut plays a critical role in shaping immune responses. Recent studies have highlighted that alterations in microbial composition, or gut dysbiosis, are related to chronic kidney disease and kidney transplantation (KT). Immunosuppressive therapies, which are essential for preventing graft rejection, can further induce significant changes in gut microbial communities, potentially influencing clinical outcomes. In KT recipients, alterations in gut microbial composition, characterized by diminished Bacteroidetes and elevated Proteobacteria, have been documented. Additionally, the expansion of potentially pathogenic bacteria, for instance, Salmonella and Escherichia coli, is indicative of a pro-inflammatory gut microbiota. These microbial alterations may affect immune responses, infection susceptibility, and graft function. Consequently, the gut microbiome represents a promising biomarker for disease diagnosis, monitoring, and evaluation of transplantation success.

Cite this article as: Gürer-Kluge EE, Kıvanç D, Çiftçi HS. The role of gut m icrobiota i n chronic k idney disease a nd o utcomes of k idney transplantation. Turk J Nephrol. Published online July 9, 2025. doi: 10.5152/turkjnephrol.2026.24911.