Compositional and functional adaptations of intestinal microbiota and related metabolites in ckd patients receiving dietary protein restriction

I. Wen Wu, Chin Chan Lee, Heng Jung Hsu, Chiao Yin Sun, Yuen Chan Chen, Kai Jie Yang, Chi Wei Yang, Wen Hun Chung, Hsin Chih Lai, Lun Ching Chang*, Shih Chi Su*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

21 Scopus citations


The relationship between change of gut microbiota and host serum metabolomics associated with low protein diet (LPD) has been unraveled incompletely in CKD patients. Fecal 16S rRNA gene sequencing and serum metabolomics profiling were performed. We reported significant changes in the β-diversity of gut microbiota in CKD patients having LPD (CKD-LPD, n = 16). We identified 19 genera and 12 species with significant differences in their relative abundance among CKD-LPD patients compared to patients receiving normal protein diet (CKD-NPD, n = 27) or nonCKD controls (n = 34), respectively. CKD-LPD had a significant decrease in the abundance of many butyrate-producing bacteria (family Lachnospiraceae and Bacteroidaceae) associated with enrichment of functional module of butanoate metabolism, leading to concomitant reduction in serum levels of SCFA (acetic, heptanoic and nonanoic acid). A secondary bile acid, glyco λ-muricholic acid, was significantly increased in CKD-LPD patients. Serum levels of indoxyl sulfate and p-cresyl sulfate did not differ among groups. The relationship between abundances of microbes and metabolites remained significant in subset of resampling subjects of comparable characteristics. Enrichment of bacterial gene markers related to D-alanine, ketone bodies and glutathione metabolism was noted in CKD-LPD patients. Our analyses reveal signatures and functions of gut microbiota to adapt dietary protein restriction in renal patients.

Original languageEnglish
Article number2799
Pages (from-to)1-16
Number of pages16
Issue number9
StatePublished - 09 2020

Bibliographical note

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.


  • Bile acids
  • Chronic kidney disease
  • Gut microbiome
  • Low protein diet
  • Short-chain fatty acids
  • Uremic solute


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