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Abstract
The number of patients on hemodialysis is increasing globally; diabetes mellitus (DM) complications is the major cause of hemodialysis in patients with chronic kidney disease (CKD). The d-amino acid (AA) profile is altered in patients with CKD; however, it has not been studied in patients with CKD and DM. Furthermore, bacteria responsible for altering the D-AA profile are not well understood. Therefore, we examined the D-AA profiles and associated bacteria in patients with CKD, with and without DM. We enrolled 12 healthy controls and 54 patients with CKD, with and without DM, and determined their salivary, stool, plasma, and urine chiral AA levels using two-dimensional high-performance liquid chromatography. We performed 16S rRNA gene sequencing analysis of the oral and gut microbiota to determine the association between the abundance of bacterial species and D-AA levels. Plasma d-alanine and d-serine levels were higher in patients with CKD than in healthy adults (p < 0.01), and plasma d-alanine levels were higher in patients with CKD and DM than in those without DM. The abundance of salivary Streptococcus, which produced d-alanine, increased in patients with CKD and DM and was positively correlated with plasma d-alanine levels. Patients with CKD and DM had unique oral microbiota and d-alanine profiles. Plasma d-alanine is a potential biomarker for patients with CKD and DM.
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1 Kanazawa University, Department of Nephrology and Laboratory Medicine, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329); Kanazawa University, Department of Clinical Laboratory, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329)
2 Kanazawa University, Department of Nephrology and Laboratory Medicine, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329); Kanazawa University, Division of Infection Control, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329)
3 Kanazawa University, Department of Nephrology and Laboratory Medicine, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329); Kanazawa University, Division of Blood Purification, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329)
4 KAGAMI Co., Ltd., Ibaragi, Japan (GRID:grid.511730.1)
5 Kyushu University, Graduate School of Pharmaceutical Sciences, Fukuoka, Japan (GRID:grid.177174.3) (ISNI:0000 0001 2242 4849)
6 RIKEN Center for Integrative Medical Sciences, Yokohama, Japan (GRID:grid.509459.4) (ISNI:0000 0004 0472 0267); The University of Tokyo, Graduate School of Frontier Sciences, Kashiwa, Japan (GRID:grid.26999.3d) (ISNI:0000 0001 2151 536X)
7 Kanazawa University, Department of Nephrology and Laboratory Medicine, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329)
8 Kanazawa University, Department of Clinical Laboratory, Kanazawa, Japan (GRID:grid.9707.9) (ISNI:0000 0001 2308 3329)
9 Kanazawa Medical University, Department of Nephrology, Kahoku, Japan (GRID:grid.411998.c) (ISNI:0000 0001 0265 5359)
10 Mizuho Hospital, Department of Internal Medicine, Kahoku, Japan (GRID:grid.411998.c)
11 Okayama University, Graduate School of Environmental and Life Science, Okayama, Japan (GRID:grid.261356.5) (ISNI:0000 0001 1302 4472)