Aiping Zhang ¹ Shilei Chen ² Yanqin Zhu ¹ Xin Zhou ¹ Mengqi Wu ¹ Bin Lu ¹ Yan Zhu ¹ Xinyu Xu ¹ Riyang Lin ^1*

• ¹ Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
• ² Hangzhou Xihu District Zhuantang Street Community Health Service Centre, Hangzhou, China

Abstract: Background Constipation is a common symptom in maintenance haemodialysis patients and greatly affects the quality of survival of haemodialysis patients. Fecal microbiota transplantation and probiotics are feasible treatments for functional constipation, but there is still a gap in the research on the characteristics of gut flora in patients with maintenance haemodialysis combined with constipation. The aim of this study is to clarify the characteristics of the intestinal flora and its changes in maintenance haemodialysis patients with constipation. Methods Fecal samples were collected from 45 participants, containing 15 in the maintenance haemodialysis constipation group,15 in the maintenance haemodialysis non-constipation group and 15 in the healthy control group. These samples were analyzed using 16S rRNA gene sequencing. The feature of the intestinal microbiome of maintenance haemodialysis constipation group and the microbiome differences among the three groups were elucidated by species annotation analysis, α-diversity analysis, β-diversity analysis, species difference analysis, and predictive functional analysis. Results The alpha diversity analysis indicated that maintenance haemodialysis constipation group was less diverse and homogeneous than maintenance haemodialysis non-constipation group and healthy control group. At the genus level, the top ten dominant genera in maintenance haemodialysis constipation group patients were Enterococcus, Escherichia-Shigella, Bacteroides, Streptococcus, Bifidobacterium, Ruminococcus_gnavus_group, Lachnospiraceae_unclassified, Faecalibacterium, Akkermansia and UCG-002. Compared with non-constipation group, the Enterococcus, Rhizobiales_unclassified, Filomicrobium, Eggerthella, Allobaculum, Prevotella_7, Gordonibacter, Mitochondria_unclassified, Lachnoanaerobaculum were significantly higher in constipation group (p<0.05). Compared with non-constipation group, the Kineothrix, Rhodopirellula, Weissella were significantly lower in constipation group (p<0.05). The predictive functional analysis revealed that compared with non-constipation group, constipation group was significantly enriched in pathways associated with pyruate metabolism, flavonoid biosynthesis. Conclusions This study describes for the first time the intestinal microbiome characteristics of maintenance haemodialysis patients with constipation. The results of this study suggest that there is a difference in the intestinal flora between maintenance haemodialysis patients with constipation and maintenance haemodialysis patients without constipation.