CKD patients comorbid with hypertension are associated with imbalanced gut microbiome

Area of Science:

• Microbiology
• Nephrology
• Gastroenterology

Background:

• Intestinal flora alterations are associated with chronic kidney disease (CKD) and hypertension.
• Understanding the gut microbiome's role in CKD and its common comorbidity, hypertension, is crucial for patient management.

Purpose of the Study:

• To investigate and compare the gut microbial community structures and functions across individuals without CKD, hypertensive CKD patients (CKD_HTN), and non-hypertensive CKD patients.
• To identify specific microbial taxa and metabolic pathways associated with CKD and hypertension.

Main Methods:

• Comparative analysis of gut microbial communities in three groups: non-CKD (n=54), CKD_HTN (n=46), and non-hypertensive CKD (n=48).
• Microbial diversity analysis, identification of distinct clusters based on variation patterns, and enrichment analysis of specific genera.
• Investigation of metabolic pathways (KEGG) and their correlation with microbial genera.

Main Results:

• Significant variations in microbial diversity were observed in CKD patients.
• A progressive increase in Prevotella-dominated types was noted from non-CKD to CKD_HTN.
• Specific genera like Klebsiella, Turicibacter, and Enterobacter were enriched in CKD, while Escherichia and Mogibacterium were elevated, and Blautia and Clostridium were reduced in CKD_HTN. Phenylalanine metabolism and siderophore biosynthesis were enhanced in CKD, especially in CKD_HTN.
• Microbial dysbiosis impacts host metabolism, with connections observed between genera and KEGG pathways.

Conclusions:

• Gut microbial dysbiosis is associated with increased susceptibility to hypertension in CKD patients.
• Specific microbial alterations and functional changes in metabolism are linked to hypertension in CKD.
• Targeting gut microorganisms and their functions may offer a strategy for improving kidney function in CKD.