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Some trial results, such as the one evaluating the suitability of NS supplementation for diabetic patients undergoing hemodialysis, have not yet been published (222)

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This dysbiotic transformation precipitates compromised SCFA biosynthetic capacity, disruption of intestinal epithelial barrier integrity, and the pathological phenomenon of intestinal hyperpermeability or leaky gut syndrome. The consequent translocation of gut-derived pathogen-associated molecular patterns (PAMPs), exemplified by lipopolysaccharides, orchestrates chronic low-grade inflammation through Toll-like receptor (TLR) activation and cascading pro-inflammatory cytokine release, thereby accelerating epithelial-mesenchymal transition within renal tubular epithelium and promoting progressive interstitial fibrogenesis (Rukavina Mikusic et al., 2020