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Association between gut microbial diversity and technique failure in peritoneal dialysis patients
Shulan Guo1,2,3,4, Huan Wu1,2,3,4, Ji Ji1,2,3,4
1Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.
Background:
Gut dysbiosis in peritoneal dialysis (PD) patients causes chronic inflammation and metabolic disorders which result in a series of complications, probably playing an important role in PD technique failure. The reduction in gut microbial diversity was a common feature of gut dysbiosis. The objective was to explore the relationship between gut microbial diversity and technique failure in PD patients.
Methods:
The gut microbiota was analyzed by 16s ribosomal RNA gene amplicon sequencing. Cox proportional hazards models were used to identify association between gut microbial diversity and technique failure in PD patients.
Results:
In this study, a total of 101 PD patients were enrolled. During a median follow-up of 38 months, we found that lower diversity was independently associated with a higher risk of technique failure (hazard ratio [HR], 2.682; 95% confidence interval [CI], 1.319-5.456; p = 0.006). In addition, older age (HR, 1.034; 95% CI, 1.005-1.063; p = 0.020) and the history of diabetes (HR, 5.547; 95% CI, 2.218-13.876; p < 0.001) were also independent predictors for technique failure of PD patients. The prediction model constructed on the basis of three independent risk factors above performed well in predicting technique failure at 36 and 48 months (36 months: area under the curve [AUC] = 0.861; 95% CI, 0.836-0.886; 48 months: AUC = 0.815; 95% CI, 0.774-0.857).
Conclusion:
Gut microbial diversity was independently correlated with technique failure in PD patients, and some specific microbial taxa may serve as a potential therapeutic target for decreasing PD technique failure.
Insights
Reduced gut microbial diversity in peritoneal dialysis (PD) patients is linked to a higher risk of PD technique failure. This finding suggests gut health is crucial for PD patient outcomes.
Area of Science:
- Microbiology
- Nephrology
- Gastroenterology
Background:
- Gut dysbiosis, characterized by reduced microbial diversity, is prevalent in peritoneal dialysis (PD) patients.
- This dysbiosis contributes to chronic inflammation and metabolic disorders, potentially leading to PD technique failure.
Purpose of the Study:
- To investigate the association between gut microbial diversity and technique failure in patients undergoing PD.
- To identify predictors of PD technique failure.
Main Methods:
- 16s ribosomal RNA gene amplicon sequencing was employed to analyze gut microbiota composition.
- Cox proportional hazards models were utilized to assess the relationship between microbial diversity and technique failure.
Main Results:
- Lower gut microbial diversity was independently associated with an increased risk of PD technique failure (HR, 2.682; p=0.006).
- Older age and a history of diabetes were also identified as independent predictors of technique failure.
- A predictive model incorporating these factors demonstrated good performance in forecasting technique failure at 36 and 48 months (AUCs of 0.861 and 0.815, respectively).
Conclusions:
- Gut microbial diversity is an independent predictor of technique failure in PD patients.
- Specific gut microbial taxa may represent potential therapeutic targets for mitigating PD technique failure.
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