{"id":"cba874f8530f","type":"article","url":"https://hartvaat.nl/2025/12/23/meta-organismaal-tryptofaanmetabolisme-als-therapeutisch-doelwit-bij-ckd-mbd/","title":"Meta-organismaal tryptofaanmetabolisme als therapeutisch doelwit bij CKD-MBD","title_en":"Meta-organismal tryptophan metabolism: an appealing therapeutic target in CKD-MBD","category":"chronische nierziekte","category_label":"Nierziekte","professions":["internist"],"tags":["anemie-ckd","cardio-renaal-metabool","cardiorenal-behandelstrategie","chronische-nierziekte","ijzertekort","microbioom"],"journal":"Kidney International","doi":"https://www.kidney-international.org/article/S0085-2538(25)01019-1/fulltext","source_url":"https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01019-1/fulltext","authors":["Guillaume Fernandes","Stéphane Burtey","Ward Zadora","Bjorn Meijers","Dieter Smout","Laura Labriola","Pieter Evenepoel"],"significance":5,"published":"2025-12-23","source_date":"2025-12-23","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/kdigo-richtlijn-ckd-2024/"],"congress":"","summary_en":"This review discusses meta-organismal tryptophan metabolism — the interplay between host and gut microbiome — as a promising therapeutic target for CKD-mineral and bone disorder. The approach represents a paradigm shift from the traditional PTH-calcium-phosphate-centric framework.","created":"2026-07-03T10:25:39Z","updated":"2026-07-03T13:25:02Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Ondanks belangrijke vooruitgang blijft CKD-MBD een grote therapeutische uitdaging. Dit overzicht bespreekt meta-organismaal tryptofaanmetabolisme — het samenspel tussen gastheer en darmmicrobioom — als veelbelovend aangrijpingspunt.","abstract_original":"Despite important advances over the past few decades, chronic kidney disease-mineral and bone disorder remains a major clinical therapeutic challenge. Traditional interventions targeting hyperphosphatemia, impaired vitamin D metabolism, and secondary hyperparathyroidism overall failed to meet expectations. This calls for a paradigm shift. The 2023 Madrid Chronic Kidney Disease-Mineral and Bone Disorder Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference advocated a holistic approach to replace the current parathyroid hormone-calcium phosphate–centric approach."}