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Diversity of the midstream urine microbiome in adults with chronic kidney disease.
Kramer, Holly; Kuffel, Gina; Thomas-White, Krystal; Wolfe, Alan J; Vellanki, Kavitha; Leehey, David J; Bansal, Vinod K; Brubaker, Linda; Flanigan, Robert; Koval, Julia; Wadhwa, Anuradha; Zilliox, Michael J.
Afiliação
  • Kramer H; Department of Public Health Sciences, Loyola University Chicago, 2160 S. First Avenue, Maywood, IL, 60153, USA.
  • Kuffel G; Medicine, Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA.
  • Thomas-White K; Hines VA Medical Center, Hines, IL, USA.
  • Wolfe AJ; Department of Public Health Sciences, Loyola University Chicago, 2160 S. First Avenue, Maywood, IL, 60153, USA.
  • Vellanki K; Departments of Microbiology and Immunology, Loyola University Chicago, Maywood, IL, USA.
  • Leehey DJ; Evy Health, 325 Sharon Park Dr., Suite 522, Menlo Park, CA, USA.
  • Bansal VK; Departments of Microbiology and Immunology, Loyola University Chicago, Maywood, IL, USA.
  • Brubaker L; Medicine, Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA.
  • Flanigan R; Hines VA Medical Center, Hines, IL, USA.
  • Koval J; Medicine, Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA.
  • Wadhwa A; Hines VA Medical Center, Hines, IL, USA.
  • Zilliox MJ; Medicine, Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, IL, USA.
Int Urol Nephrol ; 50(6): 1123-1130, 2018 Jun.
Article em En | MEDLINE | ID: mdl-29651696
PURPOSE: To examine the characteristics of the midstream urine microbiome in adults with stage 3-5 non-dialysis-dependent chronic kidney disease (CKD). METHODS: Patients with non-dialysis-dependent CKD (estimated glomerular filtration rate [eGFR] < 60 ml/min/1.73 m2) and diuretic use were recruited from outpatient nephrology clinics. Midstream voided urine specimens were collected using the clean-catch method. The bacterial composition was determined by sequencing the hypervariable (V4) region of the bacterial 16S ribosomal RNA gene. Extraction negative controls (no urine) were included to assess the contribution of extraneous DNA from possible sources of contamination. Midstream urine microbiome diversity was assessed with the inverse Simpson, Chao and Shannon indices. The diversity measures were further examined by demographic characteristics and by comorbidities. RESULTS: The cohort of 41 women and 36 men with detectable bacterial DNA in their urine samples had a mean age of 71.5 years (standard deviation [SD] 7.9) years (range 60-91 years). The majority were white (68.0%) and a substantial minority were African-American (29.3%) The mean eGFR was 27.2 (SD 13.6) ml/min/1.73 m2. Most men (72.2%) were circumcised and 16.6% reported a remote history of prostate cancer. Many midstream voided urine specimens were dominated (> 50% reads) by the genera Corynebacterium (n = 11), Staphylococcus (n = 9), Streptococcus (n = 7), Lactobacillus (n = 7), Gardnerella (n = 7), Prevotella (n = 4), Escherichia_Shigella (n = 3), and Enterobacteriaceae (n = 2); the rest lacked a dominant genus. The samples had high levels of diversity, as measured by the inverse Simpson [7.24 (95% CI 6.76, 7.81)], Chao [558.24 (95% CI 381.70, 879.35)], and Shannon indices [2.60 (95% CI 2.51, 2.69)]. Diversity measures were generally higher in participants with urgency urinary incontinence and higher estimated glomerular filtration rate (eGFR). After controlling for demographics and diabetes status, microbiome diversity was significantly associated with estimated eGFR (P < 0.05). CONCLUSIONS: The midstream voided urine microbiome of older adults with stage 3-5 non-dialysis-dependent CKD is diverse. Greater microbiome diversity is associated with higher eGFR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bacteriúria / RNA Ribossômico 16S / Microbiota / Taxa de Filtração Glomerular / Falência Renal Crônica Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Bacteriúria / RNA Ribossômico 16S / Microbiota / Taxa de Filtração Glomerular / Falência Renal Crônica Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article