Gut microbial signatures associated with uremic pruritus in hemodialysis patients

The gut microbiota influences the gut-skin-kidney axis, but its role in uremic pruritus remains poorly understood. This study aimed to explore differences in gut microbial profiles between hemodialysis (HD) patients with and without uremic pruritus and identify potential microbial signatures associated with uremic pruritus.

We conducted a cross-sectional study of HD patients with and without uremic pruritus. Stool samples were collected from all participants, and the gut microbiota composition was analyzed using 16S rRNA gene sequencing. Alpha and beta diversity metrics were calculated to assess microbial diversity. LEfSe analysis was performed to identify differentially abundant taxa associated with uremic pruritus.

Among 93 HD patients (mean age: 61.9 years, 31.2 % female), uremic pruritus occurred in 61.3 % of patients, with a median visual analog scale (VAS) score of 4.0. While alpha diversity did not differ significantly between groups, beta diversity analysis revealed significant compositional differences (unweighted UniFrac metric, P = 0.004; weighted UniFrac metric, P < 0.001). LEfSe analysis revealed significant enrichment of the order Pasteurellales, family Pasteurellaceae and genus Dialister in patients with uremic pruritus, whereas the order Corynebacteriales was more abundant in patients without pruritus (P < 0.05, LDA score > 3).

In this study, we found significant differences in gut microbiota composition between HD patients with and without uremic pruritus and identified potential microbial biomarkers for uremic pruritus. Further studies are needed to elucidate the underlying mechanisms and explore microbiota-targeted therapeutic interventions.