Characteristics of the urinary microbiome in kidney stone patients with hypertension

Fengping Liu,Yuwei Zhang,Longxian Lv,Peng Jiang,Deshui Yu,Yan Wu,Chen Li,Ninghan Feng,Xinyu Xu,Nan Zhang,Qixiao Zhai

doi:10.1186/s12967-020-02282-3

Abstract

BackgroundKidney stone disease (KSD) is more common in individuals with hypertension (HTN) than in individuals with normotension (NTN). Urinary dysbiosis is associated with urinary tract disease and systemic diseases. However, the role of the urinary microbiome in KSD complicated with HTN remains unclear.MethodsThis study investigated the relationship between the pelvis urinary microbiome and blood pressure (BP) in patients with KSD co-occurring with HTN (KSD-HTN) and healthy controls (HC) by conducting 16S rRNA gene sequencing of bacteria in urine samples. The urine samples were collected (after bladder disinfection) from 50 patients with unilateral kidney calcium stones and NTN (n = 12), prehypertension (pHTN; n = 11), or HTN (n = 27), along with 12 HCs.ResultsPrincipal coordinates analysis showed that there were significant differences in the urinary microbiomes not only between KSD patients and HCs but also between KSD-pHTN or KSD-HTN patients and KSD-NTN patients. Gardnerella dominated in HCs, Staphylococcus dominated in KSD-NTN patients and Sphingomonas dominated in both KSD-pHTN and KSD-HTN patients. The abundance of several genera including Acidovorax, Gardnerella and Lactobacillus was correlated with BP. Adherens junction and nitrogen and nucleotide metabolism pathways, among others, were associated with changes in BP.ConclusionsThe findings suggest that patients with KSD complicated with HTN have a unique urinary microbiome profile and that changes in the microbiome may reflect disease progression and may be useful to monitor response to treatments.

Highlights

Kidney stone disease (KSD) is more common in individuals with hypertension (HTN) than in individuals with normotension (NTN)
Normal BP was defined as a systolic blood pressure (SBP) ≤ 120 mmHg or a diastolic blood pressure (DBP) ≤ 80 mmHg; pHTN was defined as an SBP of 120–139 mmHg or a DBP of 80–89 mmHg without the use of antihypertensive medication; and HTN was defined as an SBP ≥ 140 mmHg or a DBP ≥ 90 mmHg and/or use of antihypertensive medication [20]
This study investigated whether the urinary microbiome of KSD patients differs according to BP

Summary

Introduction

Kidney stone disease (KSD) is more common in individuals with hypertension (HTN) than in individuals with normotension (NTN). KSD disproportionately affects patients with hypertension (HTN) compared to individuals with normal blood pressure (BP), i.e. normotension (NTN) [2]. Both KSD and HTN impair kidney function; this can lead to chronic kidney disease, which negatively affects quality of life and can be fatal [3, 4]. Low blood calcium can increase the activity of the parathyroid gland, and parathyroid hormone increases intracellular calcium in vascular smooth muscles, resulting in vasoconstriction. Low blood calcium increases the synthesis of calcitriol in a direct manner or via parathyroid hormone, and calcitriol increases intracellular calcium in vascular smooth muscle cells. Recent studies revealed that angiotensin II-induced HTN is associated with gut microbial composition and metabolites [7, 8]

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