Peritoneal Microbiome in End-Stage Renal Disease Patients and the Impact of Peritoneal Dialysis Therapy.

Liliana Simões-Silva,Isabel Soares-Silva,Benedita Sampaio-Maia,Ricardo Araujo,Manuel Pestana

doi:10.3390/microorganisms8020173

Abstract

Factors influencing the occurrence of peritoneal dialysis (PD)-related infections are still far from fully understood. Recent studies described the existence of specific microbiomes in body sites previously considered microbiome-free, unravelling new microbial pathways in the human body. In the present study, we analyzed the peritoneum of end-stage kidney disease (ESKD) patients to determine if they harbored a specific microbiome and if it is altered in patients on PD therapy. We conducted a cross-sectional study where the peritoneal microbiomes from ESKD patients with intact peritoneal cavities (ESKD non-PD, n = 11) and ESKD patients undergoing PD therapy (ESKD PD, n = 9) were analyzed with a 16S rRNA approach. Peritoneal tissue of ESKD patients contained characteristically low-abundance microbiomes dominated by Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. Patients undergoing PD therapy presented lower species richness, with dominance by the Pseudomonadaceae and Prevotelaceae families. This study provides the first characterization of the peritoneal microbiome in ESKD patients, bringing new insight to the human microbiome. Additionally, PD therapy may induce changes in this unique microbiome. The clinical relevance of these observations should be further explored to uncover the role of the peritoneal microbiome as a key element in the onset or aggravation of infection in ESKD patients, especially those undergoing PD.

Highlights

The human microbiome influences the well-being of the host by contributing to its nutrition, metabolism, physiology, and immune function, serving to maintain the balance between health and disease states [1,2,3]
Twenty end-stage kidney disease (ESKD) adult patients agreed to participate in the study between December 2014 and June 2016, and were distributed into two groups, namely, 11 ESKD patients who were scheduled for peritoneal catheter insertion (ESKD non-peritoneal dialysis (PD)) and 9 ESKD patients undergoing PD who were scheduled for catheter replacement or removal, hernia repair, or a nephrectomy (ESKD PD)
To investigate the existence of microbiomes in the peritoneum of ESKD patients, we generated a cohort of ESKD patients undergoing PD (ESKD PD) and ESKD patients before PD onset (ESKD non-PD)

Summary

Introduction

The human microbiome influences the well-being of the host by contributing to its nutrition, metabolism, physiology, and immune function, serving to maintain the balance between health and disease states [1,2,3]. Gut dysbiosis is well-described in CKD, characterized by lower levels of Bifidobacteriaceae and Lactobacillaceae and higher levels of Enterobacteriaceae [13,14]. The composition of this microbiome is affected by renal replacement therapy (RRT) used by patients with end-stage kidney disease (ESKD). Dysbiosis in more pronounced in hemodialysis (HD) patients, where increases in potentially pathogenic species and decreases in beneficial species are often observed in patients. This dysbiosis is present, to a lesser extent, in peritoneal dialysis (PD) patients when compared to controls [14,15]

Methods

Results

Conclusion