Abstract: FR-PO1110
Characterization and Modulation of Gut Microbiota in a Multiethnic Dialysis Cohort Using the Diabetic Kidney Centre Biobank: A Feasibility and Pilot Study
Session Information
- Home Dialysis: Modalities, Barriers, Utilization, and Clinical Outcomes
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Mohamed, Maha Mm, Queen Mary University of London William Harvey Research Institute, London, England, United Kingdom
- Fan, Stanley L-S, Queen Mary University of London William Harvey Research Institute, London, England, United Kingdom
Group or Team Name
- BARTS Renal Unit
Background
Dysbiosis defined as pathological alterations to a host organism's populations of bacteria may contribute to CKD progression. Short-chain fatty acids (SCFAs) are microbial metabolites produced from breakdown of fermentable fibres like lactulose by gut microbiota. SCFA health benefits include cholesterol-lowering and improving insulin resistance. Constipation is common in PD patients. Lactulose a laxative also functions as a prebiotic. We investigated gut microbiota diversity and composition in PD patients, comparing a lactulose and observational group, and assessed reliability of stool versus rectal swab sampling.
Methods
Stool and rectal swabs donated to the Diabetic Kidney Centre Biobank (DKC-B) were analysed using 16sS RNA sequencing. Incident PD patients and all patients prescribed immunosuppression, calcium acetate and sodium bicarbonate within 3 months and antibiotics within 9 weeks were excluded. A linked renal patient database was used to extract clinical details and results.
Results
Lactulose cohort showed a trend toward increased alpha diversity, Shannon (p=0.02) Simpson (p<0.02) but was not statistically significant after Bonferroni correction. ANISOM cluster analysis for beta diversity for observational (R statistic=0.1,p=1.0, lactulose (R statistic=-0.006,p=0.51) and between groups at baseline (R statistic =-0.02,p=0.56) were all insignificant.
Lactulose group showed no significant change in SCFA-associated phyla (p=0.47) with a trend towards increased SCFA-associated genera (p=0.02, dysbiosis associated genera remained unchanged(p=0.2).
No significant changes in alpha diversity(Shannon p=0.61,Simpson p=ns)or cumulative phyla or genera associated with SCFA or dysbiosis in the observational cohort, suggested microbial stability.
Strong correlation for Shannon diversity between paired stool and swab samples (F= 31.8, p=2x10^-6)suggests rectal swabs give reliable community richness and evenness. Correlation for Simpson index (Spearman p = 0.37), showed poorer agreement in identification of dominant species.
Conclusion
This is the first study to look at lactulose effects on gut microbiota in dialysis patients. Positive signals include patient tolerability, improved GI symptoms, and trends towards increased SCFA-producing bacteria providing the basis for further clinical studies.
Funding
- Clinical Revenue Support