Gembillo G, Soraci L, Visconti L. Unveiling the gut-kidney dialogue in diabetic kidney disease. World J Diabetes 2025; 16(11): 112440 [DOI: 10.4239/wjd.v16.i11.112440]
Corresponding Author of This Article
Guido Gembillo, MD, PhD, Consultant, Department of Clinical and Experimental Medicine, Unit of Nephrology and Dialysis, AOU "G. Martino", University of Messina, Via Consolare Valeria n 1, Messina 98100, Sicilia, Italy. gembillog@unime.it
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Nov 15, 2025; 16(11): 112440 Published online Nov 15, 2025. doi: 10.4239/wjd.v16.i11.112440
Unveiling the gut-kidney dialogue in diabetic kidney disease
Guido Gembillo, Luca Soraci, Luca Visconti
Guido Gembillo, Department of Clinical and Experimental Medicine, Department of Nephrology and Dialysis, AOU "G. Martino", University of Messina, Messina 98100, Sicilia, Italy
Luca Soraci, Department of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), Cosenza 87100, Calabria, Italy
Luca Visconti, Department of Nephrology and Dialysis, Ospedali Riuniti Villa Sofia Cervello, University of Palermo, Palermo 90146, Sicilia, Italy
Co-first authors: Guido Gembillo and Luca Visconti.
Author contributions: Gembillo G, Visconti L, and Soraci L contributed to the conceptualization, methodology, writing of the original draft, and review and editing. Gembillo G and Visconti L contributed equally to this work as co-first authors.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guido Gembillo, MD, PhD, Consultant, Department of Clinical and Experimental Medicine, Unit of Nephrology and Dialysis, AOU "G. Martino", University of Messina, Via Consolare Valeria n 1, Messina 98100, Sicilia, Italy. gembillog@unime.it
Received: July 27, 2025 Revised: September 8, 2025 Accepted: October 17, 2025 Published online: November 15, 2025 Processing time: 110 Days and 8.8 Hours
Abstract
Emerging evidence suggests that intestinal dysbiosis and chronic low-grade inflammation play a critical role in the development and progression of diabetic kidney disease (DKD), particularly in the elderly. Reduced microbial diversity, loss of beneficial genera and over-representation of pathogenic bacteria are closely associated with declining kidney function. There is a possible causal relationship between specific gut microbiota profiles and DKD. Experimental models also show that gut-derived metabolites and altered intestinal permeability can promote renal inflammation, fibrosis and metabolic dysfunction. This editorial discusses the implications of these findings for future research and clinical practice, emphasizing the growing potential of microbiota-targeted therapies. Understanding the gut–kidney axis could ultimately open up new avenues for precision nephrology and metabolic care.
Core Tip: Diabetic kidney disease (DKD) is increasingly recognized as a systemic condition influenced by gut microbiota and chronic low-grade inflammation. Integrating microbiome science into nephrology offers new perspectives on disease mechanisms and therapeutic strategies. This editorial highlights recent evidence supporting the gut–kidney axis as a key player in DKD progression and calls for a multidisciplinary, patient-centered approach to treatment.
