Liquid chromatography–tandem mass spectrometry (LC–MS/MS) and microbiome data reveal kidney markers of diabetic disease.
Diabetic kidney disease (DKD), a type of kidney damage caused by diabetes, is now the leading cause of kidney failure in China. A growing body of research suggests that imbalances in the communities of tiny microbes living in the body may help drive the disease forward. Even so, little is known about which microbes live in the kidneys of people with diabetic kidney disease, or what they do there.
In a recent study, researchers examined the microbes and the chemical byproducts found in kidney tissue from patients with the disease, with the goal of finding new ways to diagnose it. Kidney tissue from 42 people with diabetic kidney disease and 10 people without it was used in the study. To find out which microbes were present, the research team used a genetic test that identifies bacteria by reading a small section of their DNA. For 20 of the patients and the 10 healthy controls, liquid chromatography–tandem mass spectrometry (LC–MS/MS) was also used to measure the many small chemicals found in kidney tissue. The team then used statistical analysis to see how patients' health measurements lined up with the microbes and chemicals they found. Finally, by combining all these data, they identified possible markers that could help signal the disease. A paper based on this work was published in the journal Frontiers in Microbiology.1
DKD is one of the most common complications of type 2 diabetes, a condition that is a major health concern worldwide.2 In China alone, about 39 million people with diabetes also have chronic kidney disease. Of these, 36.9 million have protein leaking into their urine, an early warning sign of kidney damage, and 6.6 million have kidneys that are no longer filtering blood as well as they should.3 Diabetic kidney disease is now the leading cause of both chronic kidney disease and kidney failure in China. It is closely tied to serious outcomes, including severe kidney failure, a buildup of waste products in the blood (uremia), and a higher risk of death.4
Using special staining methods(immunohistochemistry [IHC] and immunofluorescence [IF]) and high-powered electron microscopes, the researchers saw bacteria in both the kidney's tiny filtering units and the small tubes that carry urine away from them. The mix of microbes in kidney tissue was clearly different in people with diabetic kidney disease than in people without it. Patients with the disease had more of certain bacteria, including Acidobacteriota, Acinetobacter, and Afipia, and less of a type called Ralstonia. Some of these bacteria were linked to signs of the disease. People with more Acinetobacter tended to have poorer kidney function, while people with more Afipia tended to have higher blood sugar. Interestingly, the microbes in the kidney looked more like those found in urine than those found in the gut.1
The chemical makeup of kidney tissue also differed between patients and healthy people. Higher levels of three substances, lactate, hypoxanthine, and phosphorylcholine, went along with better kidney function.1
The authors of the paper state that the research conducted “confirms the existence of microbiota within renal tissue and demonstrates that its structure and composition are significantly altered in DKD. These disruptions in renal microecology are closely associated with the progression of DKD. Multi-omics analysis further identified a panel of candidate markers for evaluation of DKDs.”1
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