Bacterial Populations of the Small Intestine in Uremia

Simenhoff, Michael L.; Saukkonen, Jussi; Burke, James F.; Wesson, Laurence G.; Schaedler, Russell W.; Gordon, Susan J.

doi:10.1159/000181424

Cited by 88 publications

(61 citation statements)

References 6 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The natural intestinal microbiota is disrupted in uremic patients. In 1978, Simenhoff et al reported increased numbers of both aerobic (10 6 bacteria/ml) and anaerobic (10 7 bacteria/ml) organisms in the duodenum and jejunum of patients with chronic kidney disease but very low numbers or no bacterial colonies in healthy controls (29). Hida et al found no significant difference in the total number of bacteria in the colon of hemodialysis (HD) patients and healthy controls using traditional plating methods to analyze fecal samples (13).…”

Section: Discussionmentioning

confidence: 99%

Real-Time PCR Analysis of the Intestinal Microbiotas in Peritoneal Dialysis Patients

Wang

Lai

et al. 2012

Appl Environ Microbiol

106

View full text Add to dashboard Cite

Bifidobacterium and Lactobacillus can beneficially affect the host by producing acetic acid and lactic acid, which lower pH and thereby inhibit the growth of pathogens or allow the probiotic bacteria to compete with pathogens for epithelial adhesion sites and nutrients. The transmural migration of enteric organisms into the peritoneal cavity can cause peritonitis in peritoneal dialysis (PD) patients. We hypothesized that the composition of the intestinal microbiota with regard to Lactobacillus species and Bifidobacterium species differed between PD patients and healthy controls. The aim of the study was to investigate these differences by real-time PCR analysis of fecal samples. There is a large, complex, and diverse microbial community in the human intestine. The intestinal microbiota plays an important role in digesting food, metabolizing endogenous and exogenous compounds, and producing essential vitamins. It also stimulates the immune system and prevents the colonization of the gastrointestinal tract by pathogens, and hence it influences human health (7, 9). The gastrointestinal microbiota of an adult human consists of more than 500 species, with 10 11 to 10 12 CFU per gram of stool (12,25). The predominant microorganisms are non-spore-forming, obligate anaerobes, such as Bacteroides, Fusobacterium, Eubacterium, and Bifidobacterium species. Other anaerobic bacteria found in large numbers include Lactobacillus species, various anaerobic Gram-positive cocci, and Clostridium species (4). Hida et al. studied the fecal flora of hemodialysis (HD) patients and healthy controls using traditional plating methods and found quantitative and qualitative differences between the two groups (13). It is plausible to suggest that the chronic inflammatory state in dialysis patients is in part due to a microbial imbalance in the gut, resulting in alteration of proinflammatory cytokines and production of uremic toxins from proteins fermented in the large intestine (16). Moreover, impaired intestinal barrier function in peritoneal dialysis (PD) patients allows enteric organisms to enter the peritoneal cavity by transmural migration and to cause peritonitis (8,27). Peritonitis occasionally causes death and results in significant morbidity, including catheter loss, transfer to hemodialysis, transient loss of ultrafiltration, and possible permanent membrane damage (22). Bifidobacterium and Lactobacillus can beneficially affect the host by inhibiting the growth of pathogens through production of acetic acid and lactic acid, which lower pH, or by competing with pathogens for epithelial adhesion sites and nutrients (10).To the best of our knowledge, no study has investigated the intestinal microbiota in PD patients before. The aim of this study, therefore, was to evaluate the differences in the intestinal microbiota between PD patients and healthy controls by examining fecal samples. We focused on Bifidobacterium species, Lactobacillus species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus species....

show abstract

Section: Discussionmentioning

confidence: 99%

Real-Time PCR Analysis of the Intestinal Microbiotas in Peritoneal Dialysis Patients

Wang

Lai

et al. 2012

Appl Environ Microbiol

106

View full text Add to dashboard Cite

show abstract

“…Simenhoff and colleagues [19] performed endoscopy in CKD and non-CKD individuals in the 1970s and were the first to demonstrate markedly altered gut flora in CKD patients. They noted that antibiotic treatment altered the microbiome and favorably decreased serum levels of amine toxins, concurrent with improved mentation [20].…”

Section: Altered Gut Microbiome In Ckdmentioning

confidence: 99%

“…They noted that antibiotic treatment altered the microbiome and favorably decreased serum levels of amine toxins, concurrent with improved mentation [20]. The duodenum and jejunum, which are only lightly colonized in a healthy individual, become intensely colonized by aerobic and anaerobic bacteria in uremic patients [19,21].…”

Section: Altered Gut Microbiome In Ckdmentioning

confidence: 99%

Altered microbiome in chronic kidney disease: systemic effects of gut-derived uremic toxins

et al. 2018

View full text Add to dashboard Cite

In chronic kidney disease (CKD), influx of urea and other retained toxins exerts a change in the gut microbiome. There is decreased number of beneficial bacteria that produce short-chain fatty acids, an essential nutrient for the colonic epithelium, concurrent with an increase in bacteria that produce uremic toxins such as indoxyl sulphate, p-cresyl sulphate, and trimethylamine-N-oxide (TMAO). Due to intestinal wall inflammation and degradation of intercellular tight junctions, gut-derived uremic toxins translocate into the bloodstream and exert systemic effects. In this review, we discuss the evidence supporting a role for gut-derived uremic toxins in promoting multiorgan dysfunction via inflammatory, oxidative stress, and apoptosis pathways. End-organ effects include vascular calcification, kidney fibrosis, anemia, impaired immune system, adipocyte dysfunction with insulin resistance, and low turnover bone disease. Higher blood levels of gut-derived uremic toxins are associated with increased cardiovascular events and mortality in the CKD population. Clinical trials that have examined interventions to trap toxic products or reverse gut microbial dysbiosis via oral activated charcoal AST-120, prebiotics and probiotics have not shown impact on cardiovascular or survival outcomes but were limited by sample size and short trials. In summary, the gut microbiome is a major contributor to adverse cardiovascular outcomes and progression of CKD.

show abstract

“…Literatürde diyaliz ile izlenen hastalarda HP enfeksiyonu sıklığı ile ilgili çeşitli ve çelişkili raporlar bulunmaktadır, çalışma metodları farklı olmakla beraber %17-80 gibi geniş bir aralıkta rapor edilmiştir (12)(13)(14)(15)(16). HP enfeksiyonunun, diyaliz hastalarında düşük oranlarda görüldüğü çalışmalar mevcutken, kontrol grubuna göre eşit ya da yüksek olarak sonuçlanan çalışmalar da bulunmaktadır (17-21).…”

Section: Discussionunclassified

Kronik Böbrek Yetmezliği Nedeni ile Diyaliz Yapılan Çocuklarda Helikobakter Pilori Enfeksiyonu

Genç¹,

Çaltepe²,

Özkaya³

et al. 2013

Haseki

View full text Add to dashboard Cite

1 ÖzetAmaç: Bu çalışmada, kronik böbrek yetmezlikli çocuk hastalarda gastrointestinal semptomlar ile Helicobacter pilori (HP) enfeksiyonu sıklığınının araştırılması planlanmıştır. Yöntem: Çalışmaya kronik böbrek yetmezlikli 33 hasta ile yaş ve cinsiyeti aynı olan sağlıklı kontroller dahil edildi. Hastaların demografik, serolojik ve endoskopik bulguları incelendi ve gastrointestinal sistem semptomları sorgulandı. Çalışmaya dahil edilen tüm hasta ve kontrol grubundan serumda HP-IgG düzeyi çalışıldı. Bulgular: Yirmi yedi periton diyalizi, altı hemodiyaliz hastası çalışmaya dahil edildi. HP seropozitifliği hasta grubunda %51.5, kontrol grubunda %60.6 olarak tespit edildi (p=0.46). Yirmi hastaya özefagogastroduodenoskopi uygulandı ve hastaların %30'unda dokuda HP tespit edildi. Dispepsi tüm hastaların %42.2'sinde belirlendi. Dispeptik hastaların %57.1'inde HP seropozitifliği, %36.4'ünde dokuda HP tespit edildi. Pozitif serolojisi olan hastaların %60'ında dokuda HP gösterilirken, seronegatif olan sadece bir olguda dokuda HP tespit edildi. Sonuç: Toplumumuzda sık görülen ve kolonizasyonu çocukluk yaşlarında başlayan HP enfeksiyonu, çalışmamızda da serolojik olarak hem hasta hem de kontrol grubunda yüksek bulunmuştur. Her biri transplantasyon adayı olan bu hastalar için asemptomatik olsa bile enfeksiyonun saptanması ve tedavisi önem taşımaktadır. Abs tractAim: We aimed to investigate the frequency of gastrointestinal symptoms and Helicobacter pylori (HP) infection in children with chronic renal failure. Methods: The study involved 33 patients with end-stage renal disease and 33 age-and sex-matched healthy controls. Serological, endoscopic and demographic features of the patients were determined and gastrointestinal symptoms were questioned. HP IgG levels were evaluated in all patients and controls. Results: Twenty-seven peritoneal dialysis and 6 hemodialysis patients were included in the study. The HP seropositivity was 51.5% and 60.6% in uremic children and normal controls, respectively (p=0.46). Twenty patients underwent esophagogastroduodenoscopy and HP was detected in 30% of them. Dyspepsia was observed in 42.4% of all patients. In patients with dyspepsia, HP seropositivity rate was 57.1% and biopsy proven HP was 36.4%. Biopsy proven HP was determined in 60% of patients with positive serology and in one with negative serology. Conclusion: HP infection, which is common in our population and begins in early childhood, is found to be frequent in both patient and healthy groups. Even if asymptomatic, it is very important to determine and treat this infection, in these patients who are potential transplant candidates. (The Me di cal Bul le tin of Ha se ki 2013; 51: 1-4)

show abstract

Bacterial Populations of the Small Intestine in Uremia

Cited by 88 publications

References 6 publications

Real-Time PCR Analysis of the Intestinal Microbiotas in Peritoneal Dialysis Patients

Real-Time PCR Analysis of the Intestinal Microbiotas in Peritoneal Dialysis Patients

Altered microbiome in chronic kidney disease: systemic effects of gut-derived uremic toxins

Kronik Böbrek Yetmezliği Nedeni ile Diyaliz Yapılan Çocuklarda Helikobakter Pilori Enfeksiyonu

Contact Info

Product

Resources

About