Your gut is home to trillions of bacteria that affect your whole body, including your kidneys. When you have chronic kidney disease, these bacteria can become unbalanced, which makes the disease worse. Scientists are exploring ways to fix this bacterial imbalance using special foods, dietary changes, and even transplanting healthy bacteria from donors. Some approaches show promise, like eating foods with resistant starch or adjusting your diet, but others haven’t worked as well as hoped. Researchers say we need more studies to understand exactly how gut bacteria affect kidney disease and to create personalized treatments for different people.

The Quick Take

  • What they studied: Whether changing the types of bacteria in your gut can help treat chronic kidney disease and reduce its symptoms
  • Who participated: This is a review article that summarized findings from many different studies rather than testing people directly
  • Key finding: Several approaches—like eating certain types of fiber and adjusting your diet—appear to lower harmful toxins in the blood and improve kidney function markers, though results vary and more research is needed
  • What it means for you: If you have kidney disease, dietary changes that support healthy gut bacteria may help, but these should only be done under your doctor’s guidance. This is not yet a standard treatment, and what works varies from person to person

The Research Details

This is a review article, which means scientists read and summarized research from many different studies instead of conducting their own experiment. They looked at various approaches to change gut bacteria in people with chronic kidney disease, including eating special foods (prebiotics), changing diet, taking supplements (probiotics), and in some cases, transplanting healthy bacteria from donors. The researchers examined what worked, what didn’t, and what still needs more study. This type of review helps scientists understand the big picture of what we know about a topic and where gaps in knowledge exist.

Review articles are important because they help doctors and patients understand what treatments might work and which ones need more testing. By looking at many studies together, scientists can spot patterns and see which approaches are most promising. This helps guide future research and clinical decisions.

This review was published in a respected scientific journal (Frontiers in Immunology), which means it went through quality checks. However, because it summarizes other studies rather than conducting new research, its strength depends on the quality of the studies it reviewed. The authors noted that different studies used different methods, which makes it harder to compare results. More rigorous, long-term studies are needed to confirm these findings.

What the Results Show

Several approaches showed promise for helping kidney disease patients. Eating foods with resistant starch (a type of fiber) appeared to lower harmful toxins that build up in the blood and reduce inflammation. Changing diet—such as eating less protein or avoiding gluten—seemed to improve the diversity of gut bacteria and improve kidney function markers. Transplanting healthy bacteria from donors (called fecal microbiota transplantation) showed potential for stabilizing kidney function measurements. However, the results weren’t consistent across all studies, and some approaches that seemed promising in theory didn’t work well in practice. For example, taking probiotic supplements (live bacteria pills) showed mixed results—they helped some people with blood sugar and stress markers but didn’t help everyone equally.

Some treatments that researchers tested didn’t work as expected. Supplements like propolis and cranberry extract, which were thought to help, didn’t show clear benefits. Synbiotics (combinations of prebiotics and probiotics) often changed the bacteria in the gut but didn’t always lead to real health improvements. This suggests that changing bacteria composition alone isn’t enough—the bacteria need to actually improve kidney function. The research also showed that kidney disease itself changes the gut environment in ways that make it harder for beneficial bacteria to survive, creating a difficult cycle.

This review builds on growing evidence that gut health is connected to kidney disease. Previous research showed that kidney disease patients have different bacteria than healthy people, but scientists weren’t sure if this was a cause or just a result of the disease. This review suggests it’s probably both—the disease changes the bacteria, and the changed bacteria make the disease worse. The findings support earlier work showing that diet significantly affects both gut bacteria and kidney health, but they also highlight that we still don’t fully understand the exact mechanisms involved.

The biggest limitation is that we don’t yet know for certain whether changing gut bacteria actually causes kidney disease improvement or if it’s just one piece of a larger puzzle. Different studies used different methods and measured different things, making it hard to compare results fairly. Most studies were relatively short-term, so we don’t know if benefits last over years. The review also noted that what works for one person might not work for another, but we don’t yet have good ways to predict who will benefit from which treatment. Finally, some promising approaches like phage therapy (using viruses to target bacteria) and AI-powered personalized medicine need much more research before they can be used in real patients.

The Bottom Line

If you have chronic kidney disease, talk to your nephrologist (kidney doctor) or dietitian about dietary changes that support healthy gut bacteria, such as eating more fiber-rich foods. These changes may help, but they should be personalized to your specific kidney condition and other health factors. Don’t start taking probiotic supplements or make major dietary changes without professional guidance, as some changes could harm your kidneys. Current evidence suggests dietary approaches are more reliable than supplements, but this field is still developing.

People with chronic kidney disease should pay attention to this research, as should their doctors and dietitians. If you have early-stage kidney disease, these approaches might help prevent progression. However, people with advanced kidney disease may need different dietary approaches, so personalization is crucial. This research is less relevant for people with healthy kidneys, though maintaining good gut health through diet is beneficial for everyone.

If you make dietary changes to support gut bacteria, you might notice improvements in how you feel within weeks, but measurable changes in kidney function markers typically take 2-3 months or longer. Some benefits may continue to improve over 6-12 months. However, results vary significantly between individuals, and some people may not see major improvements. This is a long-term approach, not a quick fix.

Want to Apply This Research?

  • Track weekly servings of high-fiber foods (beans, whole grains, vegetables) and note any changes in energy levels, digestion, or how you feel. Also track your kidney function test results (creatinine and GFR) every 3 months as recommended by your doctor to see if dietary changes correlate with improvements.
  • Start by adding one high-fiber food to your diet each week (such as beans, sweet potatoes, or oats) while working with your dietitian to ensure it fits your kidney disease diet plan. Log these additions and how you feel after eating them. Gradually increase fiber intake to the level your doctor recommends, tracking tolerance and any digestive changes.
  • Create a monthly dashboard showing: (1) fiber intake from food sources, (2) any probiotic or prebiotic supplements taken, (3) digestive symptoms and energy levels, and (4) kidney function test results when available. Share this with your healthcare team to see if patterns emerge between dietary changes and kidney health improvements specific to you.

This article summarizes research about gut bacteria and kidney disease but is not medical advice. Chronic kidney disease is a serious condition that requires ongoing care from a nephrologist. Do not make changes to your diet, start supplements, or change your treatment plan without first discussing with your doctor or kidney specialist. The treatments discussed in this research are still being studied and are not yet standard medical care. Results vary between individuals, and what helps one person may not help another. Always work with your healthcare team to develop a treatment plan tailored to your specific kidney condition and health needs.