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Peer-reviewedCC BYFrontiers in cellular and infection microbiology

Baseline gut microbiota and short-term response to acupressure combined with thermal stimulation in maintenance hemodialysis patients with functional constipation: an exploratory responder analysis.

3 more authors
7 affiliations
  1. 1Department of Nephrology, Hangzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
  2. 2Department of Respiratory and Critical Care Medicine, Lishui Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, China.
  3. 3Xingqiao Street Community Health Service Center, Hangzhou, Zhejiang, China.
  4. 4Department of Nephrology, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  5. 5Department of General Medicine, Hangzhou Xihu District Zhuantang Street Community Health Service Centre, Hangzhou, Zhejiang, China.
  6. 6Tianshui Wulin Street Community Health Care Centre, Hangzhou, Zhejiang, China.
  7. 7Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou, Zhejiang, China.

Abstract

Background

Constipation is common in patients undergoing maintenance hemodialysis (MHD), and individual responses to non-pharmacological interventions may vary substantially. This exploratory study investigated whether baseline gut microbiota characteristics were associated with short-term response to acupressure combined with thermal stimulation in MHD patients with functional constipation.Methods

This responder analysis was based on a randomized two-sequence crossover study. Clinical data and fecal samples obtained immediately before each participant entered the 14-day intervention period were analyzed. Participants with an increase of ≥1 bowel movement (BM) per week were classified as responders (R), and those with <1 BM/week as non-responders (NR). Baseline gut microbiota were characterized using 16S rRNA gene sequencing. Microbial diversity, taxonomic composition, and genus-level differential abundance were evaluated. ANCOM-BC2 was performed with adjustment for baseline BM/week, sex, and diabetes mellitus, followed by Benjamini-Hochberg false-discovery-rate correction and pseudocount sensitivity analysis.Results

Twenty-six participants were included, of whom 9 (34.6%) met the predefined response criterion. Across all participants, weekly BM frequency increased from 1.25 (1.00, 1.50) to 2.00 (1.00, 3.00) (P = 0.0003), while PAC-SYM total and stool-symptom subscale scores decreased (P = 0.0011 and P = 0.0013, respectively). Alpha-diversity did not differ significantly between R and NR groups, and beta-diversity showed no overall community separation (ANOSIM R=-0.044, P = 0.6751). Lactonifactor was nominally higher in responders in the unadjusted analysis (P = 0.015) but was not significant after multiple-testing correction (FDR = 0.86). In adjusted ANCOM-BC2 analysis, Veillonella (β=5.319, FDR = 0.0347) and Lactobacillus (β=3.621, FDR = 0.0459) were associated with responder status; however, neither association was robust to pseudocount sensitivity analysis. PICRUSt2 identified no significant between-group differences in predicted functional pathways.Conclusion

Baseline microbial diversity and community structure were similar between responders and non-responders. Veillonella and Lactobacillus showed adjusted associations with response, but neither was robust in sensitivity analysis. These findings should therefore be regarded as exploratory rather than predictive. Larger longitudinal studies are needed to validate these findings and determine their clinical relevance.

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BibTeX
@article{chen2026baseline,
  title = {{Baseline gut microbiota and short-term response to acupressure combined with thermal stimulation in maintenance hemodialysis patients with functional constipation: an exploratory responder analysis.}},
  author = {Saiping Chen and Mengqi Wu and Min Huang and Bin Lu and Jiarui Wang and Hong Liu and Yuqing Wang and Junyi Liu and Aiping Zhang and Yanqin Zhu and Fenggui Zhu and Xueyan Zeng and Shilei Chen and Xin Zhou and Riyang Lin},
  journal = {Frontiers in cellular and infection microbiology},
  year = {2026},
  month = oct,
  doi = {10.3389/fcimb.2026.1803544},
  url = {https://europepmc.org/article/MED/42948020},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Baseline gut microbiota and short-term response to acupressure combined with thermal stimulation in maintenance hemodialysis patients with functional constipation: an exploratory responder analysis.
AU  - Saiping Chen
AU  - Mengqi Wu
AU  - Min Huang
AU  - Bin Lu
AU  - Jiarui Wang
AU  - Hong Liu
AU  - Yuqing Wang
AU  - Junyi Liu
AU  - Aiping Zhang
AU  - Yanqin Zhu
AU  - Fenggui Zhu
AU  - Xueyan Zeng
AU  - Shilei Chen
AU  - Xin Zhou
AU  - Riyang Lin
PY  - 2026
DA  - 2026/10/13
JO  - Frontiers in cellular and infection microbiology
DO  - 10.3389/fcimb.2026.1803544
UR  - https://europepmc.org/article/MED/42948020
AB  - Background  Constipation is common in patients undergoing maintenance hemodialysis (MHD), and individual responses to non-pharmacological interventions may vary substantially. This exploratory study investigated whether baseline gut microbiota characteristics were associated with short-term response to acupressure combined with thermal stimulation in MHD patients with functional constipation.Methods  This responder analysis was based on a randomized two-sequence crossover study. Clinical data and fecal samples obtained immediately before each participant entered the 14-day intervention period were analyzed. Participants with an increase of ≥1 bowel movement (BM) per week were classified as responders (R), and those with <1 BM/week as non-responders (NR). Baseline gut microbiota were characterized using 16S rRNA gene sequencing. Microbial diversity, taxonomic composition, and genus-level differential abundance were evaluated. ANCOM-BC2 was performed with adjustment for baseline BM/week, sex, and diabetes mellitus, followed by Benjamini-Hochberg false-discovery-rate correction and pseudocount sensitivity analysis.Results  Twenty-six participants were included, of whom 9 (34.6%) met the predefined response criterion. Across all participants, weekly BM frequency increased from 1.25 (1.00, 1.50) to 2.00 (1.00, 3.00) (P = 0.0003), while PAC-SYM total and stool-symptom subscale scores decreased (P = 0.0011 and P = 0.0013, respectively). Alpha-diversity did not differ significantly between R and NR groups, and beta-diversity showed no overall community separation (ANOSIM R=-0.044, P = 0.6751). Lactonifactor was nominally higher in responders in the unadjusted analysis (P = 0.015) but was not significant after multiple-testing correction (FDR = 0.86). In adjusted ANCOM-BC2 analysis, Veillonella (β=5.319, FDR = 0.0347) and Lactobacillus (β=3.621, FDR = 0.0459) were associated with responder status; however, neither association was robust to pseudocount sensitivity analysis. PICRUSt2 identified no significant between-group differences in predicted functional pathways.Conclusion  Baseline microbial diversity and community structure were similar between responders and non-responders. Veillonella and Lactobacillus showed adjusted associations with response, but neither was robust in sensitivity analysis. These findings should therefore be regarded as exploratory rather than predictive. Larger longitudinal studies are needed to validate these findings and determine their clinical relevance.
SN  - 2235-2988
ER  -