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Open AccessArticle

Compositional and Functional Adaptations of Intestinal Microbiota and Related Metabolites in CKD Patients Receiving Dietary Protein Restriction

1
Department of Nephrology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
2
College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
3
Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkuo 33305, Taiwan
4
Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
5
Department of Medical Biotechnology and Laboratory Science and Microbiota Research Center, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
6
Department of Mathematical Sciences, Florida Atlantic University, Boca Raton, FL 33431, USA
7
Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
*
Authors to whom correspondence should be addressed.
Nutrients 2020, 12(9), 2799; https://doi.org/10.3390/nu12092799
Received: 12 August 2020 / Revised: 4 September 2020 / Accepted: 6 September 2020 / Published: 12 September 2020
(This article belongs to the Special Issue Renal Nutrition and Metabolism)
The relationship between change of gut microbiota and host serum metabolomics associated with low protein diet (LPD) has been unraveled incompletely in CKD patients. Fecal 16S rRNA gene sequencing and serum metabolomics profiling were performed. We reported significant changes in the β-diversity of gut microbiota in CKD patients having LPD (CKD-LPD, n = 16). We identified 19 genera and 12 species with significant differences in their relative abundance among CKD-LPD patients compared to patients receiving normal protein diet (CKD-NPD, n = 27) or non-CKD controls (n = 34), respectively. CKD-LPD had a significant decrease in the abundance of many butyrate-producing bacteria (family Lachnospiraceae and Bacteroidaceae) associated with enrichment of functional module of butanoate metabolism, leading to concomitant reduction in serum levels of SCFA (acetic, heptanoic and nonanoic acid). A secondary bile acid, glyco λ-muricholic acid, was significantly increased in CKD-LPD patients. Serum levels of indoxyl sulfate and p-cresyl sulfate did not differ among groups. The relationship between abundances of microbes and metabolites remained significant in subset of resampling subjects of comparable characteristics. Enrichment of bacterial gene markers related to D-alanine, ketone bodies and glutathione metabolism was noted in CKD-LPD patients. Our analyses reveal signatures and functions of gut microbiota to adapt dietary protein restriction in renal patients. View Full-Text
Keywords: bile acids; chronic kidney disease; gut microbiome; low protein diet; short-chain fatty acids; uremic solute bile acids; chronic kidney disease; gut microbiome; low protein diet; short-chain fatty acids; uremic solute
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Wu, I.-W.; Lee, C.-C.; Hsu, H.-J.; Sun, C.-Y.; Chen, Y.-C.; Yang, K.-J.; Yang, C.-W.; Chung, W.-H.; Lai, H.-C.; Chang, L.-C.; Su, S.-C. Compositional and Functional Adaptations of Intestinal Microbiota and Related Metabolites in CKD Patients Receiving Dietary Protein Restriction. Nutrients 2020, 12, 2799.

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