Wcn24-1216 Characterisation and Modulation of Gut Microbiota

Abstract

Introduction: The gut microbiota has gained immense interest in chronic kidney disease. Dysbiosis describes both quantitative and qualitative changes in microbiota composition and function in disease. CKD dysbiosis has been associated with reduced species richness, a decrease in beneficial bacteria such as Lactobacillus and Bifidobacterium, and an increase in pathogens such as Enterobacteriaceae. Additionally, the gut microbiota has a role in the progression of CKD through the production of microbiome-derived uraemic toxins. Short-chain fatty acids (SCFAs) are microbial metabolites produced from the breakdown of fermentable fibres such as lactulose or inulin, by gut microbiota. SCFA have acquired considerable attention due to their potential health benefits including anti-inflammatory effects, cholesterol-lowering, and improving insulin resistance. Peritoneal dialysis (PD) is a form of dialysis which uses a PD catheter to drain sterile PD fluid infused into the peritoneum. Constipation is common in PD patients and can lead to catheter dysfunction with poor PD fluid drainage. Therefore, PD patients are requested to take regular laxatives. Lactulose a commonly prescribed laxative also functions as a prebiotic with the potential to have a positive effect on gut microbiota. Therefore, we plan to examine changes in gut microbiota over 16 weeks when a stable cohort of prevalent PD patients start lactulose for constipation or other clinical reasons. This will be the first study looking at the effects of lactulose on modulation of the gut microbiota looking at clinical parameters such as insulin resistance and cholesterol levels in a multiethnic prevalent dialysis cohort.