Gut Microbiota in Patients on Peritoneal Dialysis

Background: In recent years, the research of the structure and role of the gut microbiota in patients with CKD has been of increasing interest due to the cumulation of data on the involvement of intestinal microflora in the onset of typical complications. The investigation of the gut microbiota in patients on peritoneal dialysis is especially relevant given the high frequency of dialysis peritonitis caused by intestinal flora, up to 40%. Methods: In our study we included 39 patients, age 55±16.4 years (22 f/17 m), who received peritoneal dialysis at our nephrology center. The intestinal microbiota was analyzed using 16s rRNA sequencing. Correlation analysis was carried out using the Pearson and Spearman coefficient. Results: Fig.1 shows microorganisms at the phylum, class, order, family and genus level in patients receiving PD. The visual shows that, on average, the prevailing phylum in the samples was Bacillota, and the second largest phylum was Bacterioidota. Bacterioidia of the Bacterioidota phylum and Clostridia and Bacilli of the Bacillota phylum were significant at the class level. The phylum Actinomycetota included the classes Coriobacteriia and Actinobacteria. At the order level, the 10 most represented taxonomic groups included Lachnospirales, Oscillospirales, Lactobacillales, Erysipelotrichales, Christensellales, Peptostreptococcales, Bacteroidales, Bifidobacteriales, Coriobacteriales and Enterobactertales. A high positive correlation (R =0.7, p<0.005) was found for ferritin and bacteria of the genera Citrobacter, Ligilactobacillus, Lactococcus, Porphyromonas, Klebsiella, Leuconostoc, Lachnoclostridium and Fusobacterium. The analysis of alpha diversity showed an inverse correlation (R -0.5,p<0.001) between the Simpson, inverted Simpson and Shannon indices and the number of peritonitis transferred, The decrease in alpha diversity was significantly inversely correlated with ferritin levels (p < 0.01). Conclusion: A decrease in the alpha diversity of microorganisms correlates with high ferritin levels and the frequency of dialysis peritonitis. There were no significant correlations with age and the studied biochemical parameters. Funding: Government Support – Non-U.S.