Disturbance of gut microbiota in chronic kidney disease

Dysbiosis of the intestinal microbiota is associated with an impaired intestinal barrier and chronic kidney disease (CKD). Identification of the relationships of gut microbiota, plasma uremic toxins, and inflammatory cytokines in patients undergoing hemodialysis (HD) may aid in the development of new treatments for kidney disease. This cross-sectional study compared the gut microbiota, plasma uremic toxins, and inflammatory cytokines in 128 patients undergoing HD, 16 non-HD patients with chronic kidney disease stage 5 (CKD5N), and 111 healthy controls (HCs). At the phylum level, disease status was associated with an increased relative abundance of Bacteroidetes and a decreased relative abundance of Firmicutes. At the genus level, the HD and CKD5N groups had greater relative abundances of Acidaminococcus, Acinetobacter, Bacteroides, and Parabacteroides, and these genera also had positive associations with the concentrations of plasma uremic toxins. Some genera that were depleted in HD patients relative to HCs (Faecalibactium, Roseburia, and Pseudobutyrivibrio) are major producers of short-chain fatty acids in the human gut. In conclusion, patients undergoing HD and those with CKD5N have pathological changes in their gut microbiota and increased production of plasma uremic toxins and inflammatory cytokines, and these may contribute to poor long-term health outcomes.