Targeting Gut Microbiome With Prebiotic in Patients With CKD: The TarGut-CKD Study

Area of Science:

• Microbiology
• Metabolomics
• Nephrology

Background:

• Gut microbiota dysbiosis is linked to metabolic disturbances in chronic kidney disease (CKD).
• Targeting the gut microbiome may offer therapeutic potential for CKD management.

Purpose of the Study:

• To investigate the efficacy of oligofructose-enriched inulin (p-inulin) in modulating the gut microbiome and its metabolic products in CKD patients.
• To assess the stability of the microbiome and metabolome during a p-inulin intervention.

Main Methods:

• A nonrandomized, open-label, 3-phase pilot trial involving 15 CKD patients.
• Repeated measures of microbiome (16S rRNA sequencing) and metabolome (untargeted metabolomics) over 8-week pretreatment, 12-week p-inulin treatment, and 8-week post-treatment phases.
• Analysis of stool, urine, and plasma samples.

Main Results:

• p-inulin administration significantly altered gut microbiota composition, notably increasing *Bifidobacterium* and *Anaerostipes* abundance.
• Microbiome and metabolome exhibited greater intersubject than intrasubject variation, indicating stability within study phases.
• Significant differences in overall metabolite profiles were observed across study phases, with enrichment in saccharolytic microbial metabolites.

Conclusions:

• p-inulin demonstrates a significant impact on the gut microbiome and host cometabolism in CKD patients.
• The findings support the stability of the gut microbiome and provide a basis for designing future microbiome-based interventions for CKD.