Traditional Chinese medicine improved diabetic kidney disease through targeting gut microbiota.

Context: Diabetic kidney disease (DKD) affects nearly 40% of diabetic patients, often leading to end-stage renal disease that requires renal replacement therapies, such as dialysis and transplantation. the gut microbiota, an integral aspect of human evolution, plays a crucial role in this condition. Traditional chinese medicine (TCM) has shown promising outcomes in ameliorating DKD by addressing the gut microbiota. Objective: this review elucidates the modifications in gut microbiota observed in DKD and explores the impact of TCM interventions on correcting microbial dysregulation. Methods: we searched relevant articles from databases including web of Science, PubMed, ScienceDirect, wiley, and Springer Nature. the following keywords were used: diabetic kidney disease, diabetic nephropathy, gut microbiota, natural product, TCM, chinese herbal medicine, and chinese medicinal herbs. Rigorous criteria were applied to identify high-quality studies on tcM interventions against DKD. Results: Dysregulation of the gut microbiota, including Lactobacillus, Streptococcus, and Clostridium, has been observed in individuals with DKD. Key indicators of microbial dysregulation include increased uremic solutes and decreased short-chain fatty acids. various TCM therapies, such as formulas, tablets, granules, capsules, and decoctions, exhibit unique advantages in regulating the disordered microbiota to treat DKD. Conclusion: this review highlights the importance of targeting the gut-kidney axis to regulate microbial disorders, their metabolites, and associated signaling pathways in DKD. The Qing-Re-Xiao-Zheng formula, the Shenyan Kangfu tablet, the Huangkui capsule, and the Bekhogainsam decoction are potential candidates to address the gut-kidney axis. TCM interventions offer a significant therapeutic approach by targeting microbial dysregulation in patients with DKD. [ABSTRACT FROM AUTHOR]

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