Gut Microbiota and Kidney Function in Autosomal Dominant Polycystic Kidney Disease Participants in Cameroon: A Cross-Sectional Study

Abstract

<title>Abstract</title> Background and hypothesis: Gut dysbiosis characterized by an imbalance in pathobionts (<italic>Enterobacter, Escherichia</italic> and <italic>Salmonella</italic>) and symbionts (<italic>Bifidobacterium, Lactobacillus</italic> and <italic>Prevotella</italic>) can occur during chronic kidney disease (CKD) progression. We evaluated the associations between representative symbionts (<italic>Bifidobacterium</italic> and <italic>Lactobacillus)</italic> and pathobionts (Enterobacteriaceae) with kidney function in persons with autosomal dominant polycystic kidney disease (ADPKD). Methods In this cross-sectional study, 29 ADPKD patients were matched to 15 controls at a 2:1 ratio. Clinical data and biological samples were collected. The estimated glomerular filtration rate (eGFR) was calculated from the serum creatinine concentration using the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Microbial DNA extracted from stool specimens and amplified by qPCR was used to quantify Enterobacteriaceae, <italic>Bifidobacterium</italic> and <italic>Lactobacillus</italic> abundance. Differences between ADPKD subgroups and controls were assessed using nonparametric tests. Results The mean age (SD) of the 44 participants was 40.65 (± 11.9) years. Among the participants with ADPKD, 62.1% experienced flank pain, and 48.3% had hypertension. Their median eGFR [IQR] was 74.4 [51.2–94.6] ml/min/1.^{73 m2}. All stool samples had Enterobacteriaceae. <italic>Lactobacillus</italic> abundance was lower in ADPKD participants with more pronounced kidney function decline (CKD G3-5: 0.58 ng/µL) than in those with milder damage and controls (G1-2: 0.64 ng/µL, p = 0.047; controls: 0.71 ng/µL, p = 0.043), while Enterobacteriaceae abundance was greater in ADPKD patients with lower kidney function (CKD G3-5: 78.6 ng/µL) than in the other two groups (G1-2: 71.6 ng/µL, p = 0.048; controls: 70.5 ng/µL, p = 0.045). Conclusion Decreased kidney function was associated with decreased symbiont and increased pathobiont abundance in ADPKD patients, suggesting a potential role for the microbiota in disease progression and possible targets for further research. Trial registration : Not applicable