The effects of Fushen Granule on the composition and function of the gut microbiota during Peritoneal Dialysis-Related Peritonitis

Wei Lin; Chen Jiang; Hangxing Yu; Lingling Wang; Jiaqi Li; Xinyue Liu; Lingyun Wang; Hongtao Yang

doi:10.1016/j.phymed.2021.153561

The effects of Fushen Granule on the composition and function of the gut microbiota during Peritoneal Dialysis-Related Peritonitis

Phytomedicine. 2021 Jun:86:153561. doi: 10.1016/j.phymed.2021.153561. Epub 2021 Mar 28.

Authors

Wei Lin¹, Chen Jiang¹, Hangxing Yu¹, Lingling Wang², Jiaqi Li¹, Xinyue Liu¹, Lingyun Wang³, Hongtao Yang⁴

Affiliations

¹ Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, PR China.
² Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
³ Division of Nephrology, Department of Medicine, Nephrology Research and Training Center, University of Alabama at Birmingham, Birmingham, AL, USA.
⁴ Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, PR China. Electronic address: tjzyyht@163.com.

PMID: 33857850
DOI: 10.1016/j.phymed.2021.153561

Abstract

Background: Peritoneal dialysis (PD) is an acknowledged treatment for patients with irreversible kidney failure. The treatment usually causes peritoneal dialysis-related peritonitis (PDRP), a common complication of PD that can lead to inadequate dialysis, gastrointestinal dysfunction, and even death. Recent studies indicated that Fushen Granule (FSG), a Chinese herbal formula, improves the treatment of PD. However, the mechanism of how FSG plays its role in the improvement is still unclear. Gut microbiota has been closely related to the development of various diseases. We carried out a randomized controlled trial to assess whether FSG can modulate the gut microbiota during PDRP treatment.

Methods: Forty-two PDRP patients were recruited into the clinical trial, and they were randomly divided into control(CON), probiotics(PRO) or Fushen granule group(FSG). To check whether FSG improve the PD treatment, we assessed the clinical parameters, including albumin(ALB), hemoglobin(HGB), blood urea nitrogen(BUN) and creatinine(CR). Fecal samples were collected before hospitalization and discharge, and stored at -80°C within 1 hour. And we assessed the microbial population and function by applying the 16S rRNA gene sequencing and functional enrichment analysis.

Results: Compared to control group, ALB is improved in both probiotics and FSG groups, while HGB is increased but BUN and CR is reduced in FSG group. Sequencing of 16S rRNA genes revealed that FSG and PRO affected the composition of the microbial community. FSG significantly increased a abundant represented by Bacteroides, Megamonas and Rothia, which was significantly correlated with the improvements in carbohydrate and amino acid metabolism.

Conclusions: This study demonstrates that FSG ameliorates the nutritional status and improves the quality of life by enriching beneficial bacteria associated with metabolism. These results indicate that FSG as alternative medicine is a promising treatment for patients with PDRP.

Keywords: 16S rRNA; Chinese herbal medicine; Gut microbiota; Peritoneal dialysis; Peritonitis.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Blood Urea Nitrogen
Drugs, Chinese Herbal / pharmacology*
Feces / microbiology
Female
Gastrointestinal Microbiome / drug effects*
Gastrointestinal Microbiome / genetics
Humans
Male
Middle Aged
Peritoneal Dialysis / adverse effects*
Peritonitis / drug therapy*
Peritonitis / etiology*
Quality of Life
RNA, Ribosomal, 16S / analysis
Serum Albumin, Human / analysis
Treatment Outcome

Substances

Drugs, Chinese Herbal
RNA, Ribosomal, 16S
Serum Albumin, Human