Hsu Chien-Ning, Lu Pei-Chen, Hou Chih-Yao, Tain You-Lin
Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan.
School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
J Clin Med. 2019 Jul 24;8(8):1090. doi: 10.3390/jcm8081090.
Both kidney disease and hypertension can originate from early life. Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of chronic kidney disease (CKD) in children. Since gut microbiota and their metabolite short chain fatty acids (SCFAs) have been linked to CKD and hypertension, we examined whether gut microbial composition and SCFAs are correlated with blood pressure (BP) load and renal outcome in CKD children with CAKUT. We enrolled 78 children with CKD stage G1-G4. Up to 65% of children with CAKUT had BP abnormalities on 24 h ambulatory blood pressure monitoring (ABPM). CKD children with CAKUT had lower risk of developing BP abnormalities and CKD progression than those with non-CAKUT. Reduced plasma level of propionate was found in children with CAKUT, which was related to increased abundance of phylum , genus and species . CKD children with abnormal ABPM profile had higher plasma levels of propionate and butyrate. Our findings highlight that gut microbiota-derived SCFAs like propionate and butyrate are related to BP abnormalities in children with an early stage of CKD. Early assessments of these microbial markers may aid in developing potential targets for early life intervention for lifelong hypertension prevention in childhood CKD.
肾脏疾病和高血压都可能起源于生命早期。先天性肾脏和尿路异常（CAKUT）是儿童慢性肾脏病（CKD）的主要原因。由于肠道微生物群及其代谢产物短链脂肪酸（SCFAs）与CKD和高血压有关，我们研究了肠道微生物组成和SCFAs是否与患有CAKUT的CKD儿童的血压（BP）负荷和肾脏结局相关。我们纳入了78名G1 - G4期CKD儿童。在24小时动态血压监测（ABPM）中，高达65%的CAKUT儿童存在血压异常。与非CAKUT儿童相比，患有CAKUT的CKD儿童发生血压异常和CKD进展的风险更低。在CAKUT儿童中发现丙酸血浆水平降低，这与门、属和种的丰度增加有关。ABPM曲线异常的CKD儿童血浆中丙酸和丁酸水平较高。我们的研究结果表明，肠道微生物群衍生的SCFAs如丙酸和丁酸与CKD早期儿童的血压异常有关。对这些微生物标志物的早期评估可能有助于为儿童CKD中预防终身高血压的生命早期干预开发潜在靶点。
