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.