Circulating Microbial Signatures and Cardiovascular Death in Patients With ESRD
Keiichi Sumida, Joseph F. Pierre, Zhongji Han, Tahliyah S. Mims, Praveen Kumar Potukuchi, M. Yuzefpolskaya, P.C. Colombo, Ryan T. Demmer, Susmita Datta, Csaba P. Kövesdy
Abstract
INTRODUCTION: Patients with end-stage renal disease (ESRD) experience disproportionately high cardiovascular morbidity and mortality. Accumulating evidence suggests a role for the circulating microbiome in the pathogenesis of cardiovascular disease; however, little is known about its association with premature cardiovascular mortality in ESRD. METHODS: In a pilot case-control study of 17 hemodialysis patients who died of a cardiovascular event and 17 matched hemodialysis controls who remained alive during a median follow-up of 2.0 years, we compared the levels and composition of circulating microbiome, including Bacteria, Archaea, and Fungi, in serum samples by quantitative polymerase chain reaction and 16S or Internal Transcribed Spacer (ITS) ribosomal RNA (rRNA) sequencing, respectively. Associations of the circulating cell-free microbial signatures with clinical parameters and cardiovascular death were examined using the Spearman rank correlation and multivariable conditional logistic regression, respectively. RESULTS: = 0.015 and 0.013, respectively) and marginally associated with risk of cardiovascular death (adjusted odds ratios [95% confidence intervals] = 1.12 [0.98-1.29] and 0.88 [0.76-1.02] for 1% increase, respectively). CONCLUSION: Alterations of the circulating cell-free microbial signatures may be associated with higher premature cardiovascular mortality in ESRD.