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An orally delivered microbial ‘cocktail’ can metabolize nitrogenous waste products in the blood and substitute for dialysis in animal models of kidney injury.

Kidney failure results in an increased buildup of toxic waste products and commonly requires dialysis, which seriously affects quality of life. Alternative strategies for replicating the functions of the kidney are needed.

Zhang et al. design an orally delivered microbiome micro-ecosystem that degrades intestinal nitrogenous waste. The administration of this in mouse and pig models of kidney injury shows that it could successfully diminish nitrogenous waste.