Gut microbiota dynamics and association with chronic kidney disease: A longitudinal study within the PREDIMED-Plus trial

Atzeni, Alessandro; Díaz López, Andrés; Hernández Cacho, Adrián; Babio, Nancy; García-Gavilán, Jesús Francisco; Cornejo-Pareja, Isabel; Belzer, Clara; Fitó Colomer, Montserrat; Tinahones Madueño, Francisco José; Salas-Salvadó, Jordi

doi:http://dx.doi.org/10.1016/j.lfs.2024.122863

Gut microbiota dynamics and association with chronic kidney disease: A longitudinal study within the PREDIMED-Plus trial

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Atzeni A, Díaz-López A, Cacho AH, Babio N, García-Gavilán JF, Cornejo-Pareja I, et al. Gut microbiota dynamics and association with chronic kidney disease: A longitudinal study within the PREDIMED-Plus trial. Life Sci. 2024 Aug 15;351:122863. DOI: 10.1016/j.lfs.2024.122863

Abstract

Aims: Chronic kidney disease (CKD) represents a global health concern, disproportionately affecting the elderly with heightened cardiovascular risk. The emerging focus on the gut microbiota's role in CKD pathophysiology represents a pivotal area in nephrology; however, the evidence on this topic is limited. This observational prospective study, in the framework of the PREDIMED-Plus trial, investigates associations between gut microbiota composition and the 1-year trajectory of CKD in 343 participants aged 55-75 years with high cardiovascular risk. Materials and methods: Kidney function was assessed at baseline and at 1-year of follow-up through the estimated glomerular filtration rate based on cystatin C (eGFR-CysC) and CKD defined by eGFR-CysC <60 mL/min/1.73 m2. Participants were grouped based on their 1-year CKD trajectory: Group 1 maintained normal status or improved from CKD to normal, while Group 2 maintained CKD or worsened from normal to CKD. Fecal microbiota composition was assessed through 16S sequencing. Key findings: We observed differences in gut microbiota composition between CKD trajectory groups. Notably, the baseline relative abundance of Lachnoclostridium and Lachnospira, both butyrate-producing genera, was lower in participants maintaining or progressing to CKD. Longitudinally, a decrease in Lachnospira abundance was associated with CKD progression. The improved Chao1 index after 1-year follow-up suggests a link between enhanced microbial richness and stable/better kidney function. Significance: The findings underscore the potential of gut microbiota analysis in non-invasively monitoring CKD, especially in older populations, and hint at future interventions targeting gut microbiota to manage CKD progression. Further research is needed for causal relationships and generalizability.