Distinct Temporal Dynamics of the Peritoneal and Gut Microbiome in Patients Undergoing Peritoneal Dialysis
Patients with kidney failure receiving peritoneal dialysis are known to exhibit alterations in their microbial ecosystems, yet how these communities evolve over time and how they relate to clinical outcomes remains insufficiently understood. This project investigates the longitudinal dynamics of microbial communities in individuals initiating long-term peritoneal dialysis, with a particular focus on contrasting changes occurring locally within the peritoneal environment versus those in the gut.Using a prospective, longitudinal design, the study integrates microbial profiling with detailed clinical, dietary, and biochemical data collected repeatedly over an extended follow-up period. Paired sampling from the peritoneal compartment and the gastrointestinal tract enables a within-patient comparison of microbial stability, resilience, and disruption across body sites exposed to markedly different physiological and treatment-related pressures.A central aim of the project is to characterize how peritoneal dialysis shapes microbial community structure over time and to determine whether observed microbial shifts are associated with systemic inflammation, metabolic perturbations, or accumulation of uremia-related solutes. The study also explores the extent to which microbial signatures detected in the peritoneal space reflect persistent community establishment versus transient exposure or residual biological material.By delineating site-specific microbial trajectories and their clinical correlates, this project seeks to advance understanding of host-microbe interactions in the context of peritoneal dialysis. The findings are intended to inform future efforts aimed at identifying microbial or metabolic biomarkers, refining risk stratification for infectious or inflammatory complications, and supporting the development of personalized strategies to improve long-term outcomes for patients undergoing peritoneal dialysis.