Exploration of the correlation between intestinal flora and peritoneal dialysis-related peritonitis

Peritonitis is a serious complication of peritoneal dialysis (PD). Gut microbiota alterations occur in end-stage renal disease (ESRD) patients. The relationship between the gut microbiota and PD-related peritonitis (PRP) is still poorly understood. It is unclear whether the intestinal flora is involved in the pathogenesis of PRP.

We collected fecal samples from PRP patients and normal group (NG) PD patients. 16S rRNA sequencing was used to analyze the gut microbiota of PRP and NG patients while also comparing the gram-positive peritonitis (GPP), Escherichia coli peritonitis (EP) and culture-negative peritonitis (CNP) groups in the subgroup analysis. The demographic data and clinical indicators of all patients were collected.

Seventeen PRP patients and 28 NG patients were recruited for this study. The analysis of fecal community diversity with 16S rDNA sequencing showed an obvious change in the microbial structure of PRP patients, where Bacteroidetes and Synergistetes were upregulated at different levels, while Bacilli and Lactobacillus were downregulated at different levels compared to levels in the NG group. In the subgroup analysis, Saccharimonadaceae was significantly increased in the GPP group compared to the EP and CNP group. In addition, decreased gene function associated with metabolic pathways was observed in PRP patients.

Bacteroidetes and Synergistetes were the dominant orders in PRP patients. The altered composition of the gut microbiota in PRP patients provided deeper insights into the pathogenesis of PRP, and these biomarkers might be established as potential therapeutic targets that deserve further exploration.