POS-667 EFFECTS OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS AND MALNUTRITION ON GUT MICROBIOTA

Abstract

Patients receiving PD who develop malnutrition have higher hospitalization rates and longer hospital stays on average, as well as significantly elevated risks of peritonitis and death.The gut microbiome in patients with kidney disease has been extensively studied. However, the relationship between nutrition status and gut microbiota in patients undergoing continuance ambulatory peritoneal dialysis (CAPD) has not received enough attention. Thirty patients diagnosed as end-stage kidney disease and treated at the peritoneal dialysis center from June 2017 to Dec 2018 were included. Thirty healthy individuals matched by gender and age were enrolled as the control group. The CAPD group was further divided into well-nourished and malnourished groups based on serum albumin level (>35 g/L and <35 g/L, respectively). The nutritional statuses of these patients were evaluated, and the feces of patients undergoing CAPD were collected for 16S rRNA gene V3 region amplification and high-throughput sequencing. The microbiota of the CAPD and control groups and the characteristics and differences of microbiota between the well-nourished and malnourished groups were compared. The average patient age was 46.3 ± 13.6 years. The primary diseases were primary glomerular disease (53.3%), diabetic nephropathy (20%), and hypertensive renal damage (26.7%). The α-diversity of bacteria in the CAPD group was significantly lower than that in the control group (P < 0.001). There were also significant differences in the β-diversity (P = 0.001). The differences between the CAPD and control groups were statistically significant in 42 flora groups. There were 36 unique operational taxonomic units in the malnourished group and 35 in the well-nourished group. The abundances of sclerenchyma and verruca microbiota were higher in the malnourished group than in the well-nourished group. Further, the abundances of Bacteroides and Macromonas were higher in the fecal flora of the malnourished group than in that of the well-nourished group. Streptococcaceae and Verrucosa were the main fecal microbiota in the malnourished group, whereas defluorinated bacteria and Megacoccus were the main bacteria in the well-nourished group. The abundance, types, and structure of the gut microbiota differed based on nutrition in patients undergoing CAPD, suggesting that there is a relationship between nutrition status and microbiota in these patients.