Fecal microbiota transplantation is a promising therapy for kidney diseases

Kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), pose growing global public health challenges. With the emergence and expanding understanding of the “microbiota–gut–kidney axis,” increasing evidence indicates that intestinal barrier disruption, abnormal microbia...

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Main Authors: Jiawei Zhang, Xiangge Ren, Bing Li, Zhifen Zhao, Shoudao Li, Wensheng Zhai
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1628722/full
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author Jiawei Zhang
Jiawei Zhang
Xiangge Ren
Xiangge Ren
Bing Li
Bing Li
Zhifen Zhao
Zhifen Zhao
Shoudao Li
Shoudao Li
Wensheng Zhai
Wensheng Zhai
author_facet Jiawei Zhang
Jiawei Zhang
Xiangge Ren
Xiangge Ren
Bing Li
Bing Li
Zhifen Zhao
Zhifen Zhao
Shoudao Li
Shoudao Li
Wensheng Zhai
Wensheng Zhai
author_sort Jiawei Zhang
collection DOAJ
description Kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), pose growing global public health challenges. With the emergence and expanding understanding of the “microbiota–gut–kidney axis,” increasing evidence indicates that intestinal barrier disruption, abnormal microbial metabolite production, and intestinal mucosal immune dysregulation play critical roles in the pathogenesis of various kidney diseases. Therapeutic modulation of the gut microbiota through probiotics, prebiotics, synbiotics, and natural products has shown potential for slowing kidney disease progression. Fecal microbiota transplantation (FMT), a direct method of reconstructing gut microbial communities, has demonstrated promise in CKD by targeting mechanisms such as inhibition of the renin–angiotensin system (RAS), attenuation of inflammation and immune activation, and restoration of intestinal barrier integrity. Although FMT has not yet been applied to AKI, its use in CKD subtypes, such as diabetic nephropathy, IgA nephropathy, membranous nephropathy, and focal segmental glomerulosclerosis, has shown encouraging preclinical and preliminary clinical results. This review systematically summarizes the current research on FMT in the context of kidney disease, evaluates its therapeutic mechanisms and feasibility, and highlights its limitations. Most studies remain in the preclinical stage, while available clinical trials are limited by small sample sizes, heterogeneous designs, and lack of standardization. To enhance the translational potential of FMT in nephrology, future studies should incorporate artificial intelligence for personalized intervention strategies and establish standardized protocols to ensure safety, efficacy, and reproducibility.
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spelling doaj-art-52a83a6bdf1e4d79af23f30770da8d672025-08-20T02:41:32ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.16287221628722Fecal microbiota transplantation is a promising therapy for kidney diseasesJiawei Zhang0Jiawei Zhang1Xiangge Ren2Xiangge Ren3Bing Li4Bing Li5Zhifen Zhao6Zhifen Zhao7Shoudao Li8Shoudao Li9Wensheng Zhai10Wensheng Zhai11The Pediatric Hospital, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, ChinaThe Pediatric Hospital, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, ChinaThe Pediatric Hospital, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, ChinaThe Pediatric Hospital, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, ChinaThe Pediatric Hospital, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, ChinaThe Pediatric Hospital, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, ChinaCollege of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, ChinaKidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), pose growing global public health challenges. With the emergence and expanding understanding of the “microbiota–gut–kidney axis,” increasing evidence indicates that intestinal barrier disruption, abnormal microbial metabolite production, and intestinal mucosal immune dysregulation play critical roles in the pathogenesis of various kidney diseases. Therapeutic modulation of the gut microbiota through probiotics, prebiotics, synbiotics, and natural products has shown potential for slowing kidney disease progression. Fecal microbiota transplantation (FMT), a direct method of reconstructing gut microbial communities, has demonstrated promise in CKD by targeting mechanisms such as inhibition of the renin–angiotensin system (RAS), attenuation of inflammation and immune activation, and restoration of intestinal barrier integrity. Although FMT has not yet been applied to AKI, its use in CKD subtypes, such as diabetic nephropathy, IgA nephropathy, membranous nephropathy, and focal segmental glomerulosclerosis, has shown encouraging preclinical and preliminary clinical results. This review systematically summarizes the current research on FMT in the context of kidney disease, evaluates its therapeutic mechanisms and feasibility, and highlights its limitations. Most studies remain in the preclinical stage, while available clinical trials are limited by small sample sizes, heterogeneous designs, and lack of standardization. To enhance the translational potential of FMT in nephrology, future studies should incorporate artificial intelligence for personalized intervention strategies and establish standardized protocols to ensure safety, efficacy, and reproducibility.https://www.frontiersin.org/articles/10.3389/fmed.2025.1628722/fullacute kidney injurychronic kidney diseasegut microbiotamicrobial-derived metabolitesfecal microbiota transplantation
spellingShingle Jiawei Zhang
Jiawei Zhang
Xiangge Ren
Xiangge Ren
Bing Li
Bing Li
Zhifen Zhao
Zhifen Zhao
Shoudao Li
Shoudao Li
Wensheng Zhai
Wensheng Zhai
Fecal microbiota transplantation is a promising therapy for kidney diseases
Frontiers in Medicine
acute kidney injury
chronic kidney disease
gut microbiota
microbial-derived metabolites
fecal microbiota transplantation
title Fecal microbiota transplantation is a promising therapy for kidney diseases
title_full Fecal microbiota transplantation is a promising therapy for kidney diseases
title_fullStr Fecal microbiota transplantation is a promising therapy for kidney diseases
title_full_unstemmed Fecal microbiota transplantation is a promising therapy for kidney diseases
title_short Fecal microbiota transplantation is a promising therapy for kidney diseases
title_sort fecal microbiota transplantation is a promising therapy for kidney diseases
topic acute kidney injury
chronic kidney disease
gut microbiota
microbial-derived metabolites
fecal microbiota transplantation
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1628722/full
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