( see related article by vanholder and glorieux . the intestine and the kidneys : a bad marriage can be hazardous .
 inflammation is a multifactorial phenotype that in chronic kidney disease is associated with adverse patient outcomes . 
 recently , alterations in gut microbiota composition and intestinal barrier have been associated with inflammation and oxidative stress in ckd patients . 
 vanholder and glorieux recently critically reviewed [ clin kidney j ( 2015 ) 8 ( 2 ) : 168 - 179 ] the current understanding of the role of gut microbiota in the production of uraemic toxins and the therapeutic implications . where do we stand now ? the basic mechanisms of the gut - kidney crosstalk must still be clarified . 
 in addition , the efficacy and safety of therapeutic strategies to modulate the gut microbiota in order to decrease uraemic toxin production and inflammation in chronic kidney disease should be evaluated . 
 finally , an impact of such strategies on hard outcomes should be demonstrated before incorporation into routine clinical practice . 
Conflict of interest statement