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NDT Advance Access originally published online on June 8, 2006
Nephrology Dialysis Transplantation 2006 21(8):2057-2060; doi:10.1093/ndt/gfl281
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Intestinal bacterial microflora—a potential source of chronic inflammation in patients with chronic kidney disease

Peter Kotanko, Mary Carter and Nathan W. Levin

Renal Research Institute, New York, NY, USA

Correspondence and offprint requests to: Nathan W. Levin, Renal Research Institute, 207 East 94th Street, Suite 303, New York, NY 10128, USA. Email: nlevin@rriny.com

Keywords: bacterial translocation; chronic inflammation; chronic kidney disease; gut; intestinal microflora

The first 150 words of the full text of this article appear below.



   Introduction
 
Inflammation is prevalent in a large proportion of dialysis patients, irrespective of the dialysis modality used. Central catheters, periodontal disease, exposure to endotoxins from non-ultrapure water dialysis and persistent chronic infections are well-established causes of chronic inflammation, but many infections go unrecognized [1].

Despite the fact that 10–100 trillion microorganisms populate the intestine in adult humans, the gastrointestinal tract has received little attention as a possible source contributing to the chronic inflammation noted in dialysis patients.

The mucosal surface is the physical interface of the immune system with the outside world, encompassing an extensive surface area of 300–400 m2, which constitutes the largest body interface between the host and microorganisms. The intestinal barrier is composed of different domains [2], the ecological barrier (the normal intestinal microflora), the mechanical barrier (single layer of polarized intestinal epithelial cells, the enterocytes, covered by mucus) and the . . . [Full Text of this Article]



   Bacterial translocation
 


   Intestinal microflora, intestinal barrier function and bacterial translocation in uraemia
 
Oral iron—a potential stimulus for intestinal bacterial growth


   Strategies to decrease intestinal permeability and bacterial translocation
 


   Conclusion
 

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