**4. Gut Microbiota-Targeted Therapy**

Recently, researchers have increasingly turned their attention on gut microbiota and its derived metabolites as a potential target for therapeutics [81,82,93,94]. In clinical practice, the most generally used gut microbiota-targeted therapies are probiotics and prebiotics. Probiotics are live bacteria that have health benefits when administered [93]. Prebiotics can promote the growth and activity of beneficial bacteria [93]. Synbiotics refer to a mixture comprising probiotic and prebiotics that also confers a health benefit. Additionally, the use of substances leased or produced through metabolism of the gut microbes, namely postbiotics, have shown a positive effect on the host [94]. Another gut microbiota-targeted therapy is fecal microbial transplantation (FMT). Although FMT is being broadly studied in microbiome-associated pathologies [95,96], its potential application for the treatment of CKD remains largely unknown. Moreover, treatment with oral intestinal absorbent AST-120 can reduce microbiota-derived uremic toxins [97]. Although AST-120 treatment has shown cardiovascular benefits in adult patients with CKD [98,99], its influence on gut microbiota compositions and other CKD-related complications remains limited. A summary of potential gut microbiota-targeted therapies in the treatment of developmental programming of CKD and its comorbidities is illustrated in Figure 2.

**Figure 2.** Schematic diagram of the potential gut microbiota-targeted therapy used for developmental programming of chronic kidney disease.
