Chronic kidney disease (CKD) is characterised by the accumulation of a myriad of uraemic retention compounds and a disruption of the intestinal barrier function contributing to chronic micro-inflammation and an increased risk for cardiovascular disease (CVD), the major cause of death in CKD patients. The Nephrology Research Unit at the Clinical Nephrology Unit of the Ghent University Hospital has a long term experience in uraemic toxicity. Many pathophysiological effects of uraemic retention compounds on different cell types (renal and cardio-vascular) have been demonstrated over the past decade, hence the name "uraemic toxins" (www.uremic-toxins.org). Many of these compounds indicated as most toxic by in vitro, in vivo and by clinical association (phenolic and indolic compounds) are generated in the colon and are very difficult to remove by dialysis therapy. For early stage prevention of inflammation and CVD in CKD and in addition to dialysis therapy in end stage kidney disease, an important alternative strategy could thus be to target the gut microbiota to decrease the primary generation of these toxins and to decrease chronic micro-inflammation as a consequence of a leaky gut. The ultimate goal is to develop therapeutic measures/therapeutic strategies to alter the intestinal generation of uraemic toxins, resulting in lowering their circulating levels, aiming at decreasing inflammation and cardiovascular morbidity and mortality in CKD patients.