[Changes of gut microflora in newly diagnosed IgA nephropathy patients and its correlation with clinical risk factors].

Objective: To investigate the gut microbiota in newly diagnosed IgA nephropathy patients with chronic kidney disease (CKD) stages 1-2 and the association between the gut microbiota and the clinical risk factors of IgA nephropathy.

Methods: Fresh fecal samples were collected from nineteen newly diagnosed IgA nephropathy patients with CKD stages 1-2 and fifteen age- and sex-matched healthy controls. Fecal bacterial DNA was extracted and microbiota composition were characterized using 16S ribosomal RNA (16S rRNA) high-throughput sequencing for the V3-V4 region. The Illumina Miseq platform was used to analyze the results of 16S rRNA high-throughput sequencing of fecal flora. At the same time, the clinical risk factors of IgA nephropathy patients were collected to investigate the association between the gut microbiota and the clinical risk factors.

Results: (1) At the phylum level, the abundance of Bacteroidetes was significantly reduced (=0.046), and the abundance of Actinobacteria was significantly increased (=0.001). At the genus level, the abundance of , and others were significantly increased ( < 0.05). The abundance of , and was significantly reduced ( < 0.05). (2) There was no significant difference in the abundance of gut microbiota between the newly diagnosed IgA nephropathy patients and the healthy control group (>0.05), but there were differences in the structure of the gut microbiota between the two groups. The results of LEfSe analysis showed that there were 16 differential bacteria in the newly diagnosed IgA nephropathy patients and healthy controls. Among them, the abundance of the newly diagnosed IgA nephropathy patients was increased in Enterobacteriales, Actinobacteria, , . The healthy control group was increased in Bacteroidetes and . (3) The result of redundancy analysis (RDA) showed that was positively correlated with serum IgA levels, 24-hour urinary protein levels and the presence of hypertension. was positively correlated with the presence of hypertension. was positively correlated with urine red blood cells account. was positively correlated with the proliferation of capillaries. was positively correlated with cell/fibrocytic crescents. was positively correlated with mesangial cell proliferation, glomerular segmental sclerosis and renal tubular atrophy/interstitial fibrosis.

Conclusion: The gut microbiota in the newly diagnosed IgA nephropathy patients with CKD stages 1-2 is different from that of the healthy controls. Most importantly, some gut bacteria are related to the clinical risk factors of IgA nephropathy. Further research is needed to understand the potential role of these bacteria in IgA nephropathy.