Differences in the Microbial Composition of Hemodialysis Patients Treated With and Without β-Blockers

Abstract

Background: β-blockers are commonly prescribed medications to treat cardiovascular disease and prevent sudden cardiac death during hemodialysis. Beyond the medication effects on the host, no study has investigated the impact of β-blocker on the gut microbiota in hemodialysis patients. Results: The β-blocker users had a higher proportion of diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, heart failure, cerebrovascular disease, and concurrent medications than non-users. After propensity score (PS) matching, there were no differences in comorbidities and concomitant medications. The α-diversity (Simpson index) increased in β-blocker users with a distinct β-diversity (Bray-Curtis Index) compared to non-users in the full cohort and PS-matched cohort. In the linear discriminative analysis effect size analysis and zero-inflated Gaussian fit model, there was a significant enrichment in the genus Flavonifractor in β-blocker users compared to non-users in the full cohort and PS-matched cohort; this was confirmed by random forest analysis. Conclusions: Hemodialysis patients using β-blocker used had a different gut microbiota composition compared to non-users, in particular, the Flavonifractor genus was significantly increased with β-blocker treatment. These findings highlight the significant impact of β-blockers on the gut microbiome in hemodialysis patients. Further research is warranted regarding the mechanisms and their clinical consequences.