Abstract: TH-PO0447
Potential Gut-Derived Circulating Mycobiota Signatures Among Patients Undergoing Hemodialysis
Session Information
- Hemodialysis: Novel Markers and Case Reports
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Mallisetty, Yamini, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Han, Zhongji, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Janjua, Hamza, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Chiu, Chi-Yang, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Chen, Cheng, The University of Tennessee Knoxville, Knoxville, Tennessee, United States
- Sumida, Maki, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Bajwa, Amandeep, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Langston, Michael Allen, The University of Tennessee Knoxville, Knoxville, Tennessee, United States
- Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Pierre, Joseph F., University of Wisconsin-Madison, Madison, Wisconsin, United States
- Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
Background
Circulating fungal DNA signatures, or circulating mycobiota (c-Myco), have recently been implicated in the pathogenesis of cardiovascular disease (CVD) in hemodialysis (HD) patients. Fungal translocation across an impaired gut barrier may contribute to the presence of pathogenic c-Myco. However, the potential gastrointestinal origin of c-Myco in HD patients remains unexplored.
Methods
In a prospective cohort of 957 HD patients, we characterized the signatures of c-Myco in baseline serum samples using internal transcribed spacer (ITS) ribosomal DNA sequencing and examined the cross-sectional association between c-Myco signatures, defined as the genus-level relative abundance (RA), and plasma lipopolysaccharide (LPS), a marker of the leaky gut phenomenon, using multivariable logistic or ordinary least squares regressions with adjustment for potential confounders.
Results
Taxonomic analysis demonstrated a total of 58 genera that were detected in >1% of patients with ITS sequence positive at a mean RA of >0.1%. Among these, we identified three potential gut-colonizing fungal genera, Cladosporium, Hannaella, and Plicaturopsis, whose higher RA was significantly associated with higher LPS levels (adjusted ORs [95% CI] for higher RA [vs. undetected], 1.71 [1.20-2.43], 2.05 [1.34-3.14], and 6.63 [1.52-28.9], respectively, Table). The association was robust for the genus Cladosporium when treating RA and LPS as continuous variables. Of note, the c-Myco signature—genus Cladosporium, a common household mold found in many foods—has been associated with CV death in HD patients.
Conclusion
We identified potential gut-derived c-Myco signatures that may contribute to high CV death in HD patients. Our findings suggest that preventing fungal entry through the gut may offer new therapeutic approaches for addressing premature CV death in HD patients.
Funding
- NIDDK Support