Evaluation of the contribution of gut microbiome dysbiosis to cardiac surgery-associated acute kidney injury by comparative metagenome analysis

Ying Li; Xinyi Jiang; Jingchun Chen; Yali Hu; Yunpeng Bai; Wang Xu; Linling He; Yirong Wang; Chunbo Chen; Jimei Chen

doi:10.3389/fmicb.2023.1119959

Evaluation of the contribution of gut microbiome dysbiosis to cardiac surgery-associated acute kidney injury by comparative metagenome analysis

Front Microbiol. 2023 Mar 17:14:1119959. doi: 10.3389/fmicb.2023.1119959. eCollection 2023.

Authors

Ying Li^{1

2

3

4}, Xinyi Jiang^{3

5}, Jingchun Chen^{3

6}, Yali Hu⁷, Yunpeng Bai⁸, Wang Xu^{2

9}, Linling He^{3

10}, Yirong Wang^{2

6}, Chunbo Chen^{2

3

11}, Jimei Chen^{1

4}

Affiliations

¹ Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
² Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
³ Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
⁴ Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China.
⁵ School of Medicine, South China University of Technology, Guangzhou, China.
⁶ School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China.
⁷ BGI College and Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China.
⁸ Center of Scientific Research, Maoming People's Hospital, Maoming, China.
⁹ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
¹⁰ Shantou University Medical College, Shantou, China.
¹¹ Department of Emergency, Maoming People's Hospital, Maoming, China.

Abstract

Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common hospital-acquired AKI that carries a grave disease burden. Recently, gut-kidney crosstalk has greatly changed our understanding of the pathogenesis of kidney diseases. However, the relationship between gut microbial dysbiosis and CSA-AKI remains unclear. The purpose of this study was to investigate the possible contributions of gut microbiota alterations in CSA-AKI patients.

Methods: Patients undergoing cardiac surgery were enrolled and divided into acute kidney injury (AKI) and Non_AKI groups. Faecal samples were collected before the operation. Shotgun metagenomic sequencing was performed to identify the taxonomic composition of the intestinal microbiome. All groups were statistically compared with alpha- and beta-diversity analysis, and linear discriminant analysis effect size (LEfSe) analysis was performed.

Results: A total of 70 individuals comprising 35 AKI and 35 Non_AKI were enrolled in the study. There was no significant difference between the AKI and Non_AKI groups with respect to the alpha-and beta-diversity of the Shannon index, Simpson or Chao1 index values except with respect to functional pathways (p < 0.05). However, the relative abundance of top 10 gut microbiota in CSA-AKI was different from the Non_AKI group. Interestingly, both LEfSe and multivariate analysis confirmed that the species Escherichia coli, Rothia mucilaginosa, and Clostridium innocuum were associated with CSA-AKI. Moreover, correlation heat map indicated that altered pathways and disrupted function could be attributed to disturbances of gut microbiota involving Escherichia coli.

Conclusion: Dysbiosis of the intestinal microbiota in preoperative stool affects susceptibility to CSA-AKI, indicating the crucial role of key microbial players in the development of CSA-AKI. This work provides valuable knowledge for further study of the contribution of gut microbiota in CSA-AKI.

Keywords: acute kidney injury; biomarker; cardiac surgery; gut microbiota dysbiosis; metagenomic sequencing.