Effect of hemodialysis and peritoneal dialysis on intestinal flora in patients with end-stage renal disease

Objective To investigate the effect of hemodialysis （HD） and peritoneal dialysis （PD） on intestinal flora in patients with end-stage renal disease （ESRD）. Methods A total of 109 subjects were divided into 4 groups： 19 healthy controls （control group）, 38 ESRD patients without dialysis （non-dialysis group）, 25 ESRD patients with continuous PD （PD group） and 27 ESRD patients with continuous HD （HD group）. The composition and function of intestinal microflora in the stool samples of the patients were analyzed by 16S rDNA sequencing. Results Compared with the healthy controls, Simpson index was significantly increased of α diversity of intestinal flora in ESRD patients without dialysis （P < 0.05）. The Observed species index, Chao1 index and Simpson index of α diversity of intestinal flora did not differ among the non-dialysis, PD and HD groups （all P > 0.05）. β diversity analysis revealed that the species composition significantly differed among four groups （all P < 0.05）. Bacteroidetes and Firmicutes were the dominant species in the control and non-dialysis groups. Compared with the non-dialysis group, the proportion of Bacteroidetes was significantly decreased in the HD group （P < 0.01）. Among them, 8 Bacteriaceae significantly differed in the classification of intestinal flora at the family level among four groups （all P < 0.05）, and the proportion of Prevotellaceae was reduced in PD and HD patients. Compared with the non-dialysis ESRD patients, the proportion of Lachnospiraceae was increased, whereas that of Desulfovibrionaceae and Porphyromonadaceae was decreased in the HD patients. The proportion of Rikenellaceae was decreased in the PD patients （all P < 0.05）. Compared with healthy subjects, the proportion of Porphyromonadaceae was significantly increased in non-dialysis ESRD patients （P < 0.05）. The proportion of Erysipelotrichaceae was increased in the intestines of non-dialysis ESRD, PD and HD patients. The proportion of Alcaligenaceae and Veillonellaceae was similar in the intestinal tracts of healthy controls, non-dialysis ESRD and PD patients, but significantly decreased in the HD patients （all P < 0.05）. Conclusion Hemodialysis dialysis and peritoneal dialysis do not significantly destroy the diversity of intestinal flora, but it changes the composition and quantity of intestinal flora in the ESRD patients.