Little is known about the relationship between gut dysbiosis, inflammation, and adverse outcomes in patients with chronic kidney disease. We examined the association of microbial diversity with all-cause mortality in hemodialysis patients. The gut microbiota was assessed by 16S ribosomal RNA gene sequencing. During a median follow-up of 2.1 years, the adjusted risk of death among patients with higher diversity (above median) was 74% lower than that among patients with lower diversity (below median). We then compared the microbial composition between nonsurvivors and survivors in a matched case-control study. We observed significantly lower microbial diversity and higher proinflammatory cytokines among nonsurvivors than survivors. Specifically, the relative abundance of Succinivibrio and Anaerostipes, two short-chain fatty acid-producing bacteria, was markedly reduced in nonsurvivors. Thus, a unique gut microbial composition is associated with an increased risk of mortality among hemodialysis patients and may be used to identify subjects with a poor prognosis.

人们对慢性肾脏病患者的肠道菌群失调、炎症和不良后果之间的关系知之甚少。我们检查了微生物多样性与血液透析患者全因死亡率的关系。通过 16S 核糖体 RNA 基因测序评估肠道微生物群。在 2.1 年的中位随访期间，具有较高多样性（高于中位数）的患者的调整后死亡风险比具有较低多样性（低于中位数）的患者低 74%。然后，我们在匹配的病例对照研究中比较了非幸存者和幸存者之间的微生物组成。我们观察到，与幸存者相比，非幸存者的微生物多样性和促炎细胞因子显着降低。具体而言，Succinivibrio和厌氧菌是两种产生短链脂肪酸的细菌，在非幸存者中显着减少。因此，独特的肠道微生物组成与血液透析患者死亡风险增加有关，可用于识别预后不良的受试者。