Boston, MA - Diabetic patients with chronic kidney disease (CKD) have higher levels of intestinal bacteria that can cause chronic inflammation, according to findings presented at the National Kidney Foundation’s Spring Clinical Meetings.
Chronic inflammation in CKD patients is linked to cardiovascular disease and increased mortality rates. The study raises the prospect that a patient’s gut microbiome could be modified to target inflammation, and that zonulin, a protein found in the digestive tract, could be measured as a therapeutic target when treating inflammation.
“Finding the right microbiome balance in the gut might significantly decrease levels of systemic inflammation and improve cardiovascular health,” said Tetyana L. Vasylyeva, MD, PhD, Tenured Professor at Texas Tech University Health Sciences Center. “We believe that manipulation of the gut microbiome could substantially change future approaches to medical care of patients with chronic kidney disease.”
This is the first study to show that CKD patients with type 2 diabetes (T2D) had significantly higher levels of Dethiosulfovibrionaceae and Syntrophomonas bacteria than control groups. Previous studies have shown that microbes associated with these bacteria could lead to inflammatory processes and the onset of inflammatory diseases such as ulcerative colitis.
“We also were surprised by the fact that microbes from the Bacteroidales and Acidimicrobioles orders, which were not detected in subjects from the control group, were present in great quantity in CKD patients with T2D,” said Ruchi Singh, PhD, Post-Doctoral Fellow, Department of Pediatrics, Division of Nephrology. “These microbes have been shown to negatively impact immune and intestinal functions by affecting gut permeability, and were strongly associated with the onset of diabetes in non-obese diabetic mice models.”
Study subjects also had higher serum concentrations of zonulin, a marker of leaky gut syndrome that was positively correlated with Lipopolysaccharide-producing bacteria, inflammatory markers and FGF-23.
The causes of inflammation in kidney disease patients can be attributed, in part, to poor nutrition due to lack of appetite, anemia, and uremia. Uremic toxins are linked to CKD progression and a number of these toxins originate from the gut bacteria. In addition, researchers also believe that many drugs or compounds used in the treatment of CKD may compromise a healthy gut microbiome.
“We are just at the beginning of great discovery, that reflects metabolic changes linked to disruptions in the gut microbiome,” said Dr. Vasylyeva. “Further understanding and manipulation of human microbiota may allow effective prevention and treatment of many diseases.”
The NKF 2016 Spring Clinical Meetings are being held April 27 to May 1, in Boston, MA. For additional program information, and to register, visit www.NKFClinicalMeetings.org.
The National Kidney Foundation is the leading organization in the U.S. dedicated to the awareness, prevention and treatment of kidney disease. For more information, visit www.kidney.org.