Abstract
Chronic kidney disease (CKD) is a major public health burden around the world. The gut microbiome may contribute to CKD progression and serve as a promising therapeutic target. Colonic dialysis has long been used in China to help remove gut-derived toxins to delay CKD progression. Since disturbances in the gut biome may influence disease progression, we wondered whether colonic dialysis may mitigate the condition by influencing the biome. We compared the gut microbiota, based on 16S rRNA gene sequencing, in fecal samples of 25 patients with CKD (stages 3–5) who were receiving colonic dialysis(group CD), 25 outpatients with CKD not receiving colonic dialysis(group OP), and 34 healthy subjects(group HS). Richness of gut microbiota was similar between patients on colonic dialysis and healthy subjects, and richness in these two groups was significantly higher than that in patients not on colonic dialysis. Colonic dialysis also altered the profile of microbes in the gut of CKD patients, bringing it closer to the profile in healthy subjects. Colonic dialysis may protect renal function in pre-dialysis CKD by mitigating dysbiosis of gut microbiota.
Highlights
Chronic kidney disease (CKD) is a major public health burden around the world
We provide here the first evidence that colonic dialysis may increase the diversity of the gut microbiome in patients with pre-dialysis CKD, even up to the levels observed in healthy individuals
We found that CKD patients not receiving colonic dialysis had significantly higher abundances of Proteobacteria as well as aerobic and facultative anaerobic bacteria than healthy subjects, consistent with previous work[23,24,25]
Summary
Chronic kidney disease (CKD) is a major public health burden around the world. The gut microbiome may contribute to CKD progression and serve as a promising therapeutic target. Colonic dialysis has long been used in China to help remove gut-derived toxins to delay CKD progression. In China, colonic dialysis has long been applied to patients with pre-dialysis CKD (stages 3–5) as a simple, inexpensive procedure to remove uremic toxins. CKD has been associated with dysbiosis of gut microbiota[8,9], which has been linked to other chronic diseases such as inflammatory bowel disease, colorectal cancer, diabetes, obesity and multiple system atrophy[10,11,12,13,14] Such dysbiosis can affect the pharmacokinetics of some drugs[15]. Toxins in the gut, which may exacerbate kidney d isease[17] This vicious circle is often called the “gut–kidney” axis, highlighting the gut microbiome as a potential cause of CKD progression and a therapeutic t arget[18]
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