ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1671036
Alterations in Gut-Kidney Axis Indicators and TMAO-Related Biomarkers in Elderly Patients with Hypertensive Nephropathy
Provisionally accepted
Ziyi Li1,2
Shi Yang3Xinyi Zhou1,2Qin Yan4Tiyan Zhang4Wenliu Xu3Wei Duan1,2
Fajian Ren1,2Hua Deng1,2Wenjing Wang5Ming Li6Min Feng6*
Rao Chaolong1,2*- 1Chengdu University of Chinese Medicine, Cheng Du, China
- 2School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- 3Longquanyi Center for Disease Control and Prevention, Chengdu, China
- 4Longquan Ping’an Community Health Service Center, Chengdu, China
- 5Chengdu Association of Vision Protection and Health Promotion, Chengdu, China
- 6Chengdu Center for Disease Control and Prevention, Chengdu, China
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Growing evidence suggests that gut microbiota may influence renal function via the gut-kidney axis. This study assessed gut microbial composition, metabolic indicators, and inflammatory markers in elderly individuals with varying degrees of hypertensive kidney involvement. Seventy participants were stratified into three groups: healthy controls, hypertensive without renal impairment, and hypertensive with chronic kidney disease. The chronic kidney disease group exhibited elevated serum urea and creatinine and reduced eGFR, along with increased levels of KIM-1, NGAL, IL-18, TNF-α, IL-6, NF-κB, and FMO3. Urinary TMAO was significantly decreased in both hypertensive groups, while serum TMAO remained unchanged. Although α-and β-diversity indices were comparable across groups, compositional shifts were noted, including higher relative abundance of Escherichia-Shigella and Haemophilus and lower levels of Faecalibacterium. Correlation analyses revealed associations between specific genera and host metabolic or inflammatory markers, such as a positive correlation between Enterobacter and urinary TMAO, and inverse correlations between Veillonella and both eGFR and urinary TMAO. Functional prediction indicated increased amino acid metabolism in the chronic kidney disease group. These findings suggest interrelated patterns involving gut microbial composition, toxin handling, and inflammatory status in elderly hypertensive individuals, supporting further investigation into microbiota-associated biomarkers within the framework of the gut-kidney axis.
Keywords: Gut Microbiota, Hypertensive renal dysfunction, Trimethylamine N-oxide, 16S rRNA sequencing, Cross-sectional study
Received: 23 Jul 2025; Accepted: 14 Aug 2025.
Copyright: © 2025 Li, Yang, Zhou, Yan, Zhang, Xu, Duan, Ren, Deng, Wang, Li, Feng and Chaolong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Min Feng, Chengdu Center for Disease Control and Prevention, Chengdu, China
Rao Chaolong, Chengdu University of Chinese Medicine, Cheng Du, China
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