Abstract:

Diabetic kidney disease （DKD） stands as one of the most prevalent and severe microvascular complications of diabetes mellitus （DM）， serving as the primary cause of chronic kidney disease （CKD） and end-stage renal disease （ESRD）. This imposes a substantial burden on both patients and society from health and economic perspectives. The gut microbiota represents the aggregate of all microorganisms inhabiting the human intestine， forming an extremely intricate and extensive ecosystem. The organic interplay between the gut microbiota and the kidneys has been verified to directly or indirectly influence human health. Specifically， dysbiosis of the gut microbiota， impairment of the intestinal barrier， and imbalance of gut microbiota metabolites can initiate oxidative stress and immune-inflammatory responses， thereby accelerating the progression of DKD. In recent years， traditional Chinese medicine has manifested unique advantages in the prevention and treatment of DKD， attributed to its multi-target approach， holistic regulation， and minimal side effects. Studies have revealed that various compounds， including monosaccharide glycosides， flavonoids， polyphenols， terpenoids， alkaloids， polysaccharides， as well as traditional Chinese medicine formulas categorized as removing blood stasis and clearing turbidity， tonifying qi and nourishing yin， and clearing heat and detoxifying， can regulate the gut microbiota， target relevant signaling pathways， alleviate renal damage， and delay the progression of DKD. This article systematically reviews the key mechanisms through which the gut microbiota is involved in DKD， analyzes the research achievements in regulating the gut microbiota for the treatment of DKD in recent years， and aims to offer new insights and directions for the prevention and treatment of DKD with traditional Chinese medicine.

Key words: diabetic kidney disease, gut microbiota, traditional chinese medicine