High-throughput sequencing analysis of intestinal flora changes in ESRD and CKD patients

Abstract

Background: Chronic kidney disease (CKD) disease affects gut flora by causing dysbiosis and lead to systemic inflammatory conditions. Here, we provide intestinal flora changes of CKD patients undertook different hemodialysis therapy. Methods: From 2017 to 2019, a total of 166 patients from Guangzhou Red Cross Hospital were recruited and divided into four groups with 17 cases in healthy control group, 47 cases in CKD non-dialysis group, 49 cases in HD group, and 53 cases in PD group. Intestinal flora genome 16S rDNA sequencing and further bio-informatic analysis were performed.Results: Decreased diversity and altered communities of intestinal flora in PD patients, in which microbial diversity was positive correlated with the albumin level were observed. A total of 20 intestinal flora phyla were detected in 166 fecal samples, divided into 3 dominant intestinal types including Bacteroides-dominant gut type, Firmicutesdominant type and Proteobacteria-dominant gut type. Further analyses found 198 genera, the abundance of 86 genera were significantly different. Butyrate-producing taxa as Faecalibacterium in genera level and Bifidobacteriaceae and Prevotellaceae in family level were dominant genus in CT, CKD, and HD groups, while urease containing-, indole-and p-cresol-forming taxa as Escherichia in genera and Enterobacteriaceae, Enterococcaceae in family level was dominated genus in PD group. Number of differential expressed genes in KEGG enrichment pathways were significantly different in PD group in carbohydrate metabolism, amino acid metabolism, energy metabolism, translation, and membrane transport. Conclusion: Our results suggest peritoneal dialysis therapy could result in reduced diversity and altered microbial communities, with reduced probiotic butyrate-producing taxa and increased urease containing-, indole-and pcresol-forming taxa. The disordered intestinal flora can seriously affect the nutrition level in CKD patients with PD therapy.

The Effects of Hemodialysis and Peritoneal Dialysis on the Gut Microbiota of End-Stage Renal Disease Patients, and the Relationship Between Gut Microbiota and Patient Prognoses

“…In addition, no significant effect of PD on the gut microbiota of ESRD patients was found in our study. By contrast, Hu et al compared the gut microbiota of PD, HD, non-dialysis CKD and healthy control group, and reported that PD reduced microbial diversity, decreased probiotic butyrate production microbiota, and increased urease -, indole -and p-cresol formation microbiota (Hu J, et al, 2020). The main reason that may explain the difference of results between our study and the study by Hu et al is likely that the differences in the inflammatory state and age of the subjects, which are known to have important influences on the gut microbiota (Borges et al, 2016;Takagi et al, 2019).…”

“…By contrast, Hu et al. compared the gut microbiota of PD, HD, non-dialysis CKD and healthy control group, and reported that PD reduced microbial diversity, decreased probiotic butyrate production microbiota, and increased urease -, indole - and p-cresol formation microbiota ( Hu J, et al., 2020 ). The main reason that may explain the difference of results between our study and the study by Hu et al.…”

Gut microbiota in Immunoglobulin A Nephropathy: a Malaysian Perspective

“…Dysbiosis of the gut microbiome is increasingly recognised to be associated with various medical conditions including chronic kidney disease (CKD) [15][16][17][18]. Vaziri et al demonstrate that CKD was associated with lower diversity and richness of gut microbiota and attributed these to the elevated urea in CKD [18].…”

Effect of Unripe Banana Flour on Gut-Derived Uremic Toxins in Individuals Undergoing Peritoneal Dialysis: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial

“…Studies have shown that CKD is associated with altered colonic microbiota composition [ 18 , 19 , 20 , 21 ]. Among these changes, increased bacterial families with producers of indole and p-cresol were observed, suggesting a potentially upregulated microbiota in the production of these metabolites [ 19 ].…”