Changes in intestinal flora and its correlation with renal function in chronic renal failure patients / 中华肾脏病杂志

ABSTRACT

Objective To investigate changes in intestinal bacteria in chronic renal failure (CRF),their diagnostic value for CRF,and correlations between specific bacterial genera and renal function.Methods Fecal specimens were collected from 56 patients with CRF and 38 healthy controls in the Nephrology Department and Medical Examination Center of Shanxi People's Hospital between August 2017 and January 2018.High-throughput sequencing analysis of 16S rDNA V3-V4 hypervariable regions was performed for intestinal bacteria.Intestinal bacteria in CRF patients and healthy subjects were analyzed for alpha,beta diversity,species composition analysis,and differential species analysis.The diagnostic value of the presence of specific intestinal bacteria for CRF was analyzed using a receiver operating characteristic curve (ROC).Pearson's correlation analysis was used to analyze the correlation between the presence of specific genera and the estimated glomerular filtration rate (eGFR).Results The alpha and beta diversity in the CRF group was different from that in the control group (P ＜ 0.05).At the phylum level,Verrucomicrobia were significantly less abundant in the CRF group than that in the control group (0.70％ vs 3.09％,P ＜ 0.001).The abundance of Actinobacteria was significantly greater in the CRF group than that in the control group (1.48％ vs 1.14％,P=0.036).At the genus level,the abundance of Akkermansia (0.96％ vs 3.90％),Parasutterella (0.47％ vs 0.93％),and Lactobacillus (0.07％ vs 0.48％) in the CRF group was significantly less than those in the control group (all P ＜ 0.01).The abundance of Alloprevotella (0.41％ vs 0.04％) and Clostridium Ⅳ (0.6％ vs 0.1％) was significantly greater than those in the control group (all P ＜ 0.05).The diagnostic value of CRF for the area under the ROC curve (AUC) for Akkermansia was 0.753,and that for Lactobacillus diagnostic value of CRF was 0.792.The combined AUC diagnostic value of CRF for detection of Akkermansia and Lactobacillus was 0.830,with high disease prediction value.Lactobacillus abundance was positively correlated with eGFR (R=0.29,P=0.029).Conclusions The diversity and structure of intestinal bacteria are altered in patients with CRF.The abundance of Akkermansia and Lactobacillus has diagnostic value for CRF.The abundance of Lactobacillus is positively correlated with eGFR.