Differences in Gut Microbiota Profiles and Functions Between End-stage Renal Disease and Healthy Populations 

2020 ◽  
Author(s):  
Ping-Hsun Wu ◽  
Ting-Yun Lin ◽  
Hsiu J. Ho ◽  
Ching-Hung Tseng ◽  
Yi-Ting Lin ◽  
...  

Abstract Background: Patients with end-stage renal disease (ESRD) have extremely high risks of mortality and morbidity, as well as altered gut microbiota and impaired intestinal barrier function. The translocation of gut-derived molecules in ESRD contributes to systemic complications. In this study, we evaluated the gut microbiome difference in ESRD patients compared to age- and gender-matched subjects without kidney disease in discovery and validation cohorts.Results: Compared to controls with normal renal function, an increased α-diversity and distinct β-diversity were found in ESRD subjects. The increase in α-diversity was correlated with protein-bound uremic toxins, particularly hippuric acid. A higher microbial dysbiosis index (MDI) was found in ESRD patients with the following enriched genera: Facealibacterium, Ruminococcus, Fusobacterium, Dorea, Anaerovorax, Sarcina, Akkemansia, Streptococcus, and Dysgonomonas. MDI at the genus level demonstrated highly differentiated accuracies between ESRD and control subjects in the discovery cohort (area under the curve [AUC] of 81.9%) and between ESRD and control subjects in the validation cohort (AUC of 83.2%). On functional enrichment analysis with gut metabolic modules, ESRD subjects presented with increased saccharide and amino acid metabolism when compared with matched controls.Conclusions: An enriched but dysbiotic gut microbiota was presented in ESRD patients, in which the bacteria that were present increase amino acid metabolism linked to the production of protein-bound uremic toxins.

2020 ◽  
Author(s):  
Gholamreza Hanifi ◽  
Hamid Tayebi Khosroshahi ◽  
Reza Shapouri ◽  
Mohammad Asgharzadeh ◽  
Hossein Samadi Kafil

Abstract Background: Bifidobacteriaceae family are belonged to the gut microbiota that could exhibit probiotic or health promoting effects on the host. Several studies suggested that gut microbiota are quantitative and qualitative altered in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The present study was aimed to assess the members of Bifidobacteriaceae family in fecal samples of patients with CKD and ESRD in compared to non-CKD/ESRD patients to find any changes of their counts in these patients.Methods: Twenty fresh fecal samples of patients with CKD/ESRD and twenty from non-CKD/ESRD patients were included. The whole DNA of fecal samples were extracted and the gut microbiota composition was analyzed by next generation sequencing (NGS) method.Results: Total 651 strains were identified from 40 fecal samples, which 8 (1.23%) strains were identified as family Bifidobacteriaceae. The most abundance species in both control and disease group were Bifidobacterium adolescentis (2.10% ± 1.05% vs. 1.98% ± 1.53%, respectively) and the lowest abundance species in disease group was Bifidobacterium animalis subsp. lactis (0.0007% ± 0.0009%).Conclusions: There was no significant differentiation in the abundance of various species between disease group and control group (p<0.05). This study has confirmed that the members of Bifidobacteriaceae family are not alters in patients with CKD/ESRD.


2014 ◽  
Vol 21 (1) ◽  
Author(s):  
Titiek Hidayati ◽  
Yuningtyaswari Yuningtyaswari ◽  
Ahmad Hamim Sadewa ◽  
Marsetyawan HNE Soesatyo

Objective: To identify the Insulin-like Growth Factor–1 (IGF-1) level of End Stage Renal Disease (ESRD) and non ESRD populations, and correlation between IGF-1level and ESRD incidences. Material & Method: This case study was carried out in Yogyakarta with 72 volunteers. The cases involved Chronic Kidney Disease (CKD) patients. The controls were non-CKD patients. CKD parameters were established with PERNEFRI diagnostic criteria. Comparison of IGF-1 levels between case and control groups was performed through ANOVA, with confidence level of 95%. Bivariate analysis to identify the correlation between IGF-1 plasma level, smoking status, illness history and body mass index (BMI) by determining odds ratio (OR) of individual risk factor of p < 0.05. Results: We enrolled 72 volunteers, 45 male and 27 female subjects. Of the 45 male patients, 15 CKD and 30 non CKD patients served as cases and controls, respectively. The difference in plasma IGF-1 level was detected in the case and control groups (42.01 ± 10.66 vs. 56.05 ± 24.91) (p < 0.05). The result of bivariate analysis showed passive smoking status, IGF-1 plasma level, DM history and hypertensive illness history had correlation with ESRD incidence with odds ratios of 7.88 (p < 0.005; CI: 1.6-37.5) for passive smokers, 4.3 (p < 0.05, CI: 1.36 to 13.33) for IGF-1 level, 21.5 (p < 0.05; CI) for DM history and 12.4 (p < 0.05; CI: 3.7 to 41) for hypertensive history. Conclusion: There was difference in IGF-1 plasma level between ESRD and non-ESRD patients. The IGF-1 plasma level, passive smoking status, diabetes history, and hypertensive history have correlation with ESRD incidence.Keywords: Insulin-like Growth Factor–1 level, End Stage Renal Disease, case control, odds ratio.


Author(s):  
Dan Luo ◽  
Wenbo Zhao ◽  
Zhiming Lin ◽  
Jianhao Wu ◽  
Hongchun Lin ◽  
...  

Gut microbiota alterations occur in end-stage renal disease (ESRD) patients with or without dialysis. However, it remains unclear whether changes in gut microbiota of dialysis ESRD patients result from dialysis or ESRD, or both. Similarly, there is a dearth of information on the relationship between gut microbiota and ESRD prognoses. We collected fecal samples and tracked clinical outcomes from 73 ESRD patients, including 33 pre-dialysis ESRD patients, 19 peritoneal dialysis (PD) patients, and 21 hemodialysis (HD) patients. 16S rRNA sequencing and bioinformatics tools were used to analyze the gut microbiota of ESRD patients and healthy controls. Gut microbiota diversity was different before and after dialysis. Bacteroidetes were significantly deceased in HD patients. Twelve bacterial genera exhibited statistically significant differences, due to dialysis (all P &lt; 0.05, FDR corrected). HD reversed abnormal changes in Oscillospira and SMB53 in pre-dialysis patients. Functional predictions of microbial communities showed that PD and HD altered signal transduction and metabolic pathways in ESRD patients. Furthermore, Bacteroides and Phascolarctobacterium were associated with cardiovascular mortality. Dorea, Clostridium, and SMB53 were related to peritonitis in PD patients. This study not only demonstrated differences in gut microbiota between pre-dialysis and dialysis ESRD patients, but also firstly proposed gut bacteria may exert an impact on patient prognosis.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ping-Hsun Wu ◽  
Ting-Yun Lin ◽  
Hsiu J Ho ◽  
Ching-Hung Tseng ◽  
Yi-Ting Lin ◽  
...  

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) are characterized by altered gut microbiota, impaired intestinal barrier function, and experienced gut microbiota-derived metabolites related to systemic complications. However, limited studies evaluated the microbial diversity and function in ESKD patients previously. Method Compared to age- and gender-matched subjects without kidney disease, 82 ESKD patients in the discovery cohort and 58 ESKD patients in the validation cohort were investigated for the microbial richness, biodiversity, gut dysbiosis, microbial composition differences, and the functional changes by gut metabolic module analysis. Bacterial derived free form protein-bound uremic toxins were analyzed by mass spectrometry and their association with microbial richness in ESKD patients was determined. Results Compared to controls, an increased α-diversity and distinct β-diversity were found in ESKD (Figure). The increase in α-diversity was correlated with protein-bound uremic toxins, particularly hippuric acid. A higher microbial dysbiosis index (MDI) was found in ESKD patients with the following enriched genera: Facealibacterium, Ruminococcus, Fusobacterium, Dorea, Anaerovorax, Sarcina, Akkermansia, Streptococcus, and Dysgonomonas. MDI at the genus level successfully differentiated between ESKD and controls in the discovery cohort (area under the curve [AUC] of 81.9%) and the validation cohort (AUC of 83.2%). Regarding functional enrichment analysis with gut metabolic modules, ESKD subjects presented with gut microbial function of increased saccharide and amino acid metabolism compared with matched controls. Conclusion An enriched but dysbiotic gut microbiota was presented in ESKD patients, in which the bacteria that were present increase amino acid metabolism linked to the production of protein-bound uremic toxins.


1983 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Glen H Stanbaugh ◽  
A. W, Holmes Diane Gillit ◽  
George W. Reichel ◽  
Mark Stranz

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.


2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 298-302
Author(s):  
Robert H. Mak ◽  
Wai Cheung

Cachexia is common in end-stage renal disease (ESRD) patients, and it is an important risk factor for poor quality of life and increased mortality and morbidity. Chronic inflammation is an important cause of cachexia in ESRD patients. In the present review, we examine recent evidence suggesting that adipokines or adipocytokines such as leptin, adiponectin, resistin, tumor necrosis factor α, interleukin-6, and interleukin-1β may play important roles in uremic cachexia. We also review the physiology and the potential roles of gut hormones, including ghrelin, peptide YY, and cholecystokinin in ESRD. Understanding the molecular pathophysiology of these novel hormones in ESRD may lead to novel therapeutic strategies.


Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.


2007 ◽  
Vol 98 (08) ◽  
pp. 339-345 ◽  
Author(s):  
Johannes Sidelmann ◽  
Mikkel Brabrand ◽  
Robert Pedersen ◽  
Jørgen Pedersen ◽  
Kim Esbensen ◽  
...  

SummaryFibrin clots with reduced permeability, increased clot stiffness and reduced fibrinolysis susceptibility may predispose to cardiovascular disease (CVD). Little is known, however, about the structure of fibrin clots in patients with end-stage renal disease (ESRD).These patients suffer from a high risk of CVD in addition to their chronic low-grade inflammation. Using permeability, compaction and turbidity studies in 22 ESRD patients and 24 healthy controls, fibrin clots made from patient plasma were found to be less permeable (p<0.001), less compactable (p<0.001), and less susceptible to fibrinolysis (p<0.001) than clots from controls.The maximum rate of turbidity increase was also higher for the patients than controls (p<0.001), and scan-ning electron microscopy revealed higher clot density of fibrin fibers in clots from patients than clots from controls (p<0.001). Patients had higher plasma concentrations of fibrinogen, C-reative protein and interleukin 6 than controls.These plasma markers of inflammation correlated significantly with most of the fibrin structure characteristics observed in the patients. In contrast, plasma markers of azothemia showed no such correlations. The results suggest that in ESRD patients fibrin clots are significantly different from healthy controls, and that the fibrin structure characteristics in the patients are associated primarily with the inflammatory plasma milieu rather than with level of azothemia.


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