Differences in Gut Microbiota Composition Are an Important Reason for Lower Serum P-Cresol Sulfate Levels in anuric Peritoneal Dialysis Patients Compared to Hemodialysis Patients
Highlights • Distinct microbial communities are found in peritoneal dialysis (PD) and paired hemodialysis (HD) patients, despite similar microbiome diversity. • Serum p-cresyl sulfate (PCS) levels are significantly lower in PD patients compared to paired HD patients. • Altered microbial composition in PD patients, featuring more opportunistic pathogens and fewer beneficial bacteria, is linked to differences in metabolite profiles. • Fecal transplant experiments confirm that the HD-associated gut microbiota directly leads to higher PCS production. • Targeting the gut microbiota presents a potential therapeutic strategy to reduce uremic toxins in dialysis patients.