Abstract: TH-PO1058

The Role of Gut Microbiota in Phosphorus Metabolism in Maintenance Hemodialysis Patients

Session Information

Category: Mineral Disease

  • 1201 Mineral Disease: Ca/Mg/PO4

Authors

  • Miao, Yuanyi, Peking University First Hospital, Beijing, China
  • Xia, Min, Renal Division, Peking University First Hospital, Beijing, China
  • Chen, Yuqing, Renal Division, Peking University First Hospital, Beijing, China
Background

Disturbance of phosphorus metabolism is a risk factor associated with mortality in hemodialysis patients. Gut absorption is the major source of phosphorus. Recent studies indicated that the intestinal flora of uremic patients changed a lot. And phosphorus is an essential element of bacterial survival and reproduction. The purpose of the study was to explore the role of intestinal microbiota in the control of serum phosphorus.

Methods

Microbial DNA was isolated from the stools of 20 healthy controls and 21 maintenance hemodialysis patients from one hemodialysis center. 14 out of the 21 patients were treated with Lanthanum carbonate for 12 weeks, thus stools were also collected before and after the treatment. The bacterial composition was analyzed by 16S ribosomal RNA pyrosequencing. Bioinformatics tools, including abundance profiling, taxonomic diversity and correlation analyses were used in microbiome data analyses.

Results

Clinical biochemical traits were compared before and after the use of Lanthanum carbonate in MHD patients. The serum phosphorus decreased after using Lanthanum carbonate for 12 weeks (P<0.001). There was no difference in other traits. 13 genera were closely correlated with serum phosphorus and the correlation coefficient was above 0.4 (P<0.05). And 11 genera were positively related to serum phosphorus, suggesting that survival of the 11 genera were related to phosphorus. We also found that 2 genera were negatively related to serum phosphorus, indicating that the 2 bacteria may be involved in the absorption process of phosphorus. 58 bacterial operational taxonomic units (OTUs) were different before and after the use of phosphorus binder. More decreased OTUs were identified after using phosphorus binder. 7 genera were obviously reduced, including Centipeda, Chryseobacterium, Gemella, unclassified_Rhodocyclaceae, Pelomonas, Curvibacter and Parvimonas. Furthermore, the microbial richness and diversity decreased in hemodialysis patients and declined further after phosphorus reduction.

Conclusion

Gut flora is related to phosphorus metabolism in hemodialysis patients, and improving intestinal microbiota may regulate the absorption of phosphorus in the intestine. The use of phosphorus reduction drugs lead to decreased microbial richness and diversity.

Funding

  • Government Support - Non-U.S.