Eje intestino–riñón: avances recientes y aplicaciones clínicas en nefrología pediátrica y del adulto

Vicente Martinez Cardenas; Vivian R. Mena Miranda

doi:10.12873/1089Martinez

Autores/as

Vicente Martinez Cardenas Children’s Medical Center. Lake city. Florida. USA. https://orcid.org/0000-0002-6273-2501
Vivian R. Mena Miranda Hospital pediátrico Centro. La Habana, Cuba.

DOI:

https://doi.org/10.12873/1089Martinez

Palabras clave:

Eje intestino–riñón; Microbiota intestinal; Enfermedad renal crónica; Pediatría; Ácidos grasos de cadena corta

Resumen

Introducción: El eje intestino–riñón representa la interacción bidireccional entre microbiota intestinal y función renal. Se ha asociado a progresión de enfermedad renal crónica (ERC), inflamación sistémica y complicaciones cardiovasculares. Objetivo: Revisar los hallazgos más recientes (2020–2025) sobre los mecanismos, metabolitos implicados y estrategias terapéuticas relacionadas con el eje intestino–riñón, con énfasis en población pediátrica. Material y método: Se realizó búsqueda sistemática en PubMed, Scopus y Web of Science (enero 2020–junio 2025) con los términos gut-kidney axis, uremic toxins, short-chain fatty acids y children. Se incluyeron estudios originales, revisiones y guías clínicas. Resultados: La disbiosis intestinal aumenta toxinas urémicas (indoxil sulfato, p-cresil sulfato, TMAO), asociadas a inflamación, fibrosis y peor pronóstico renal. Los ácidos grasos de cadena corta ejercen efectos protectores inmunomoduladores. En pediatría, niveles elevados de indoxil sulfato se correlacionan con menor velocidad de crecimiento. Intervenciones como dietas ricas en fibra (KDIGO 2024), probióticos/simbióticos y adsorbentes intestinales (AST-120) muestran beneficio potencial. Conclusiones: El eje intestino–riñón emerge como determinante clave en la progresión de ERC y sus complicaciones. Los metabolitos derivados de la microbiota constituyen biomarcadores y posibles dianas terapéuticas. En población pediátrica se requieren ensayos clínicos para establecer recomendaciones específicas.

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