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中华肾病研究电子杂志 ›› 2026, Vol. 15 ›› Issue (04) : 224 -229. doi: 10.3877/cma.j.issn.2095-3216.2026.04.008

综述

胆汁酸代谢在慢性肾脏病中的研究进展
赵思媛, 白琼(), 唐雯   
  1. 100191 北京大学第三医院肾内科
  • 收稿日期:2025-04-19 出版日期:2026-08-28
  • 通信作者: 白琼
  • 基金资助:
    北京大学第三医院临床重点项目(BYSYZD2021036); 北京大学第三医院人才孵育基金(BYSYFY2021025)

Research progress of bile acid metabolism in chronic kidney disease

Siyuan Zhao, Qiong Bai(), Wen Tang   

  1. Department of Nephrology, Peking University Third Hospital, Beijing 100191, China
  • Received:2025-04-19 Published:2026-08-28
  • Corresponding author: Qiong Bai
引用本文:

赵思媛, 白琼, 唐雯. 胆汁酸代谢在慢性肾脏病中的研究进展[J/OL]. 中华肾病研究电子杂志, 2026, 15(04): 224-229.

Siyuan Zhao, Qiong Bai, Wen Tang. Research progress of bile acid metabolism in chronic kidney disease[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2026, 15(04): 224-229.

肠肾轴是介导肠道与肾脏信号交流的核心通路,肠道菌群通过调控胆汁酸代谢成为肠肾轴的关键调控节点。胆汁酸代谢不仅参与机体糖脂代谢、肠道微生态平衡、炎症免疫调节等病理生理过程,还可通过肠肾轴介导的信号通路影响肾脏功能,参与血脂异常、动脉粥样硬化、慢性肾脏病(chronic kidney disease,CKD)等进展。CKD可诱发肠肾轴失衡,导致肠道菌群紊乱及胆汁酸谱异常;紊乱的胆汁酸谱可通过促进肾脏纤维化、干扰脂代谢、诱导微炎症等机制推动CKD进展。目前相关证据多来源于动物实验及临床关联性观察,胆汁酸代谢与CKD之间的因果调控关系仍有待进一步论证。

The gut-kidney axis is a core pathway mediating signal communication between the gut and the kidney, and the gut microbiota acts as a key regulatory node of the gut-kidney axis by regulating bile acid metabolism. Bile acid metabolism not only participates in various pathophysiological processes such as glucose and lipid metabolism, intestinal microecological balance, and inflammatory immune regulation, but also affects renal function through gut-kidney axis-mediated signaling pathways, and is involved in the progression of dyslipidemia, atherosclerosis, chronic kidney disease (CKD), etc. CKD can induce gut-kidney axis imbalance, resulting in intestinal microbiota disturbance and abnormal bile acid profiles. The disrupted bile acid profiles can promote CKD progression through mechanisms such as accelerating renal fibrosis, interfering with lipid metabolism, and triggering micro-inflammation. At present, relevant evidence is mostly derived from animal experiments and clinical observational association studies, and the causal regulatory relationship between bile acid metabolism and CKD remains to be further verified.

图1 "肠-胆汁酸-肾轴"在慢性肾脏病中的调控机制图
表1 靶向胆汁酸代谢治疗慢性肾脏病的潜在策略
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