Gut microbiome and blood purification_West China Medical Journal

Authors：

TANG Zijing ¹ ,  PAN Yu ¹ ,  DING Feng ^1,2

1. Division of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, P. R. China;
2. Shanghai Key Laboratory of Gut Microecology and Associated Major Diseases Research, Shanghai 200011, P. R. China;

Corresponding author：

PAN Yu, Email: panyu1980@163.com; DING Feng, Email: dingfeng@sjtu.edu.cn

Keywords：

Chronic kidney disease; gut microbiome; blood purification; treatment strategy

DOI：

10.7507/1002-0179.202306136

Video：

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End-stage renal disease is a late complication of chronic kidney disease (CKD) and one of the leading causes of high mortality worldwide. Over the years, the impacts of gut microbiota and their associated uremic toxins on kidney diseases through the intricate “gut-kidney axis” have been extensively studied. However, translation of microbiome-related omics results into specific mechanisms is still a significant challenge. In this paper, we review the interaction between gut microbiome and blood purification, as well as the current microbiota-based therapies in CKD. Additionally, the current sequencing technologies and progresses in the gut microbiome research are also discussed.

Citation： TANG Zijing, PAN Yu, DING Feng. Gut microbiome and blood purification. West China Medical Journal, 2023, 38(7): 974-978. doi: 10.7507/1002-0179.202306136 Copy

1.	Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the Sixth China Chronic Disease and Risk Factor Surveillance. JAMA Intern Med, 2023, 183(4): 298-310.
2.	Yang C, Yang Z, Wang J, et al. Estimation of prevalence of kidney disease treated with dialysis in China: a study of insurance claims data. Am J Kidney Dis, 2021, 77(6): 889-897.
3.	Snauwaert E, Van Biesen W, Raes A, et al. Haemodiafiltration does not lower protein-bound uraemic toxin levels compared with haemodialysis in a paediatric population. Nephrol Dial Transplant, 2020, 35(4): 648-656.
4.	Wong J, Piceno YM, DeSantis TZ, et al. Expansion of urease- and uricase-containing, indole- and p-cresol-forming and contraction of short-chain fatty acid-producing intestinal microbiota in ESRD. Am J Nephrol, 2014, 39(3): 230-237.
5.	Lemos DR, McMurdo M, Karaca G, et al. Interleukin-1 β activates a MYC-dependent metabolic switch in kidney stromal cells necessary for progressive tubulointerstitial fibrosis. J Am Soc Nephrol, 2018, 29(6): 1690-1705.
6.	Kim HY, Yoo TH, Hwang Y, et al. Indoxyl sulfate (IS)-mediated immune dysfunction provokes endothelial damage in patients with end-stage renal disease (ESRD). Sci Rep, 2017, 7(1): 3057.
7.	Kim HY, Yoo TH, Cho JY, et al. Indoxyl sulfate-induced TNF-α is regulated by crosstalk between the aryl hydrocarbon receptor, NF-κB, and SOCS2 in human macrophages. FASEB J, 2019, 33(10): 10844-10858.
8.	Azevedo MLV, Bonan NB, Dias G, et al. p-Cresyl sulfate affects the oxidative burst, phagocytosis process, and antigen presentation of monocyte-derived macrophages. Toxicol Lett, 2016, 263: 1-5.
9.	Shiba T, Kawakami K, Sasaki T, et al. Effects of intestinal bacteria-derived p-cresyl sulfate on Th1-type immune response in vivo and in vitro. Toxicol Appl Pharmacol, 2014, 274(2): 191-199.
10.	Beaman M, Michael J, MacLennan IC, et al. T-cell-independent and T-cell-dependent antibody responses in patients with chronic renal failure. Nephrol Dial Transplant, 1989, 4(3): 216-221.
11.	Juergensen PH, Finkelstein FO, Brennan R, et al. Pseudomonas peritonitis associated with continuous ambulatory peritoneal dialysis: a six-year study. Am J Kidney Dis, 1988, 11(5): 413-417.
12.	Szeto CC, Chow VCY, Chow KM, et al. Enterobacteriaceae peritonitis complicating peritoneal dialysis: a review of 210 consecutive cases. Kidney Int, 2006, 69(7): 1245-1252.
13.	Bossola M, Sanguinetti M, Scribano D, et al. Circulating bacterial-derived DNA fragments and markers of inflammation in chronic hemodialysis patients. Clin J Am Soc Nephrol, 2009, 4(2): 379-385.
14.	Lin TY, Wu PH, Lin YT, et al. Gut dysbiosis and mortality in hemodialysis patients. NPJ Biofilms Microbiomes, 2021, 7(1): 20.
15.	Ren ZG, Fan YJ, Li A, et al. Alterations of the human gut microbiome in chronic kidney disease. Adv Sci, 2020, 7(20): 2001936.
16.	Luo D, Zhao W, Lin Z, et al. The effects of hemodialysis and peritoneal dialysis on the gut microbiota of end-stage renal disease patients, and the relationship between gut microbiota and patient prognoses. Front Cell Infect Microbiol, 2021, 11: 579386.
17.	Wu IW, Lin CY, Chang LC, et al. Gut microbiota as diagnostic tools for mirroring disease progression and circulating nephrotoxin levels in chronic kidney disease: discovery and validation study. Int J Biol Sci, 2020, 16(3): 420-434.
18.	Wu IW, Gao SS, Chou HC, et al. Integrative metagenomic and metabolomic analyses reveal severity-specific signatures of gut microbiota in chronic kidney disease. Theranostics, 2020, 10(12): 5398-5411.
19.	Meijers BKI, De Preter V, Verbeke K, et al. p-Cresyl sulfate serum concentrations in haemodialysis patients are reduced by the prebiotic oligofructose-enriched inulin. Nephrol Dial Transplant, 2010, 25(1): 219-224.
20.	Kelly JT, Palmer SC, Wai SN, et al. Healthy dietary patterns and risk of mortality and ESRD in CKD: a meta-analysis of cohort studies. Clin J Am Soc Nephrol, 2017, 12(2): 272-279.
21.	Yamaguchi J, Tanaka T, Inagi R, et al. Effect of AST-120 in chronic kidney disease treatment: still a controversy?. Nephron, 2017, 135(3): 201-206.
22.	Fujii H, Nishijima F, Goto S, et al. Oral charcoal adsorbent (AST-120) prevents progression of cardiac damage in chronic kidney disease through suppression of oxidative stress. Nephrol Dial Transplant, 2009, 24(7): 2089-2095.
23.	Nakamura T, Sato E, Fujiwara N, et al. Oral adsorbent AST-120 ameliorates tubular injury in chronic renal failure patients by reducing proteinuria and oxidative stress generation. Metabolism, 2011, 60(2): 260-264.
24.	Prakash S, Chang TMS. Microencapsulated genetically engineered live E. coli DH5 cells administered orally to maintain normal plasma urea level in uremic rats. Nat Med, 1996, 2(8): 883-887.
25.	Lauriero G, Abbad L, Vacca M, et al. Fecal microbiota transplantation modulates renal phenotype in the humanized mouse model of IgA nephropathy. Front Immunol, 2021, 12: 694787.

1. Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the Sixth China Chronic Disease and Risk Factor Surveillance. JAMA Intern Med, 2023, 183(4): 298-310.
2. Yang C, Yang Z, Wang J, et al. Estimation of prevalence of kidney disease treated with dialysis in China: a study of insurance claims data. Am J Kidney Dis, 2021, 77(6): 889-897.
3. Snauwaert E, Van Biesen W, Raes A, et al. Haemodiafiltration does not lower protein-bound uraemic toxin levels compared with haemodialysis in a paediatric population. Nephrol Dial Transplant, 2020, 35(4): 648-656.
4. Wong J, Piceno YM, DeSantis TZ, et al. Expansion of urease- and uricase-containing, indole- and p-cresol-forming and contraction of short-chain fatty acid-producing intestinal microbiota in ESRD. Am J Nephrol, 2014, 39(3): 230-237.
5. Lemos DR, McMurdo M, Karaca G, et al. Interleukin-1 β activates a MYC-dependent metabolic switch in kidney stromal cells necessary for progressive tubulointerstitial fibrosis. J Am Soc Nephrol, 2018, 29(6): 1690-1705.
6. Kim HY, Yoo TH, Hwang Y, et al. Indoxyl sulfate (IS)-mediated immune dysfunction provokes endothelial damage in patients with end-stage renal disease (ESRD). Sci Rep, 2017, 7(1): 3057.
7. Kim HY, Yoo TH, Cho JY, et al. Indoxyl sulfate-induced TNF-α is regulated by crosstalk between the aryl hydrocarbon receptor, NF-κB, and SOCS2 in human macrophages. FASEB J, 2019, 33(10): 10844-10858.
8. Azevedo MLV, Bonan NB, Dias G, et al. p-Cresyl sulfate affects the oxidative burst, phagocytosis process, and antigen presentation of monocyte-derived macrophages. Toxicol Lett, 2016, 263: 1-5.
9. Shiba T, Kawakami K, Sasaki T, et al. Effects of intestinal bacteria-derived p-cresyl sulfate on Th1-type immune response in vivo and in vitro. Toxicol Appl Pharmacol, 2014, 274(2): 191-199.
10. Beaman M, Michael J, MacLennan IC, et al. T-cell-independent and T-cell-dependent antibody responses in patients with chronic renal failure. Nephrol Dial Transplant, 1989, 4(3): 216-221.
11. Juergensen PH, Finkelstein FO, Brennan R, et al. Pseudomonas peritonitis associated with continuous ambulatory peritoneal dialysis: a six-year study. Am J Kidney Dis, 1988, 11(5): 413-417.
12. Szeto CC, Chow VCY, Chow KM, et al. Enterobacteriaceae peritonitis complicating peritoneal dialysis: a review of 210 consecutive cases. Kidney Int, 2006, 69(7): 1245-1252.
13. Bossola M, Sanguinetti M, Scribano D, et al. Circulating bacterial-derived DNA fragments and markers of inflammation in chronic hemodialysis patients. Clin J Am Soc Nephrol, 2009, 4(2): 379-385.
14. Lin TY, Wu PH, Lin YT, et al. Gut dysbiosis and mortality in hemodialysis patients. NPJ Biofilms Microbiomes, 2021, 7(1): 20.
15. Ren ZG, Fan YJ, Li A, et al. Alterations of the human gut microbiome in chronic kidney disease. Adv Sci, 2020, 7(20): 2001936.
16. Luo D, Zhao W, Lin Z, et al. The effects of hemodialysis and peritoneal dialysis on the gut microbiota of end-stage renal disease patients, and the relationship between gut microbiota and patient prognoses. Front Cell Infect Microbiol, 2021, 11: 579386.
17. Wu IW, Lin CY, Chang LC, et al. Gut microbiota as diagnostic tools for mirroring disease progression and circulating nephrotoxin levels in chronic kidney disease: discovery and validation study. Int J Biol Sci, 2020, 16(3): 420-434.
18. Wu IW, Gao SS, Chou HC, et al. Integrative metagenomic and metabolomic analyses reveal severity-specific signatures of gut microbiota in chronic kidney disease. Theranostics, 2020, 10(12): 5398-5411.
19. Meijers BKI, De Preter V, Verbeke K, et al. p-Cresyl sulfate serum concentrations in haemodialysis patients are reduced by the prebiotic oligofructose-enriched inulin. Nephrol Dial Transplant, 2010, 25(1): 219-224.
20. Kelly JT, Palmer SC, Wai SN, et al. Healthy dietary patterns and risk of mortality and ESRD in CKD: a meta-analysis of cohort studies. Clin J Am Soc Nephrol, 2017, 12(2): 272-279.
21. Yamaguchi J, Tanaka T, Inagi R, et al. Effect of AST-120 in chronic kidney disease treatment: still a controversy?. Nephron, 2017, 135(3): 201-206.
22. Fujii H, Nishijima F, Goto S, et al. Oral charcoal adsorbent (AST-120) prevents progression of cardiac damage in chronic kidney disease through suppression of oxidative stress. Nephrol Dial Transplant, 2009, 24(7): 2089-2095.
23. Nakamura T, Sato E, Fujiwara N, et al. Oral adsorbent AST-120 ameliorates tubular injury in chronic renal failure patients by reducing proteinuria and oxidative stress generation. Metabolism, 2011, 60(2): 260-264.
24. Prakash S, Chang TMS. Microencapsulated genetically engineered live E. coli DH5 cells administered orally to maintain normal plasma urea level in uremic rats. Nat Med, 1996, 2(8): 883-887.
25. Lauriero G, Abbad L, Vacca M, et al. Fecal microbiota transplantation modulates renal phenotype in the humanized mouse model of IgA nephropathy. Front Immunol, 2021, 12: 694787.

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