Background Cognitive impairment is widely prevalent in maintenance hemodialysis (MHD) patients, and seriously afects their quality of life. The intestinal fora likely regulates cognitive function, but studies on cognitive impairment and intestinal fora in MHD patients are lacking.

Methods MHD patients (36) and healthy volunteers (18) were evaluated using the Montreal Cognitive Function Scale, basic clinical data, and 16S ribosome DNA (rDNA) sequencing. Twenty MHD patients and ten healthy volunteers were randomly selected for shotgun metagenomic analysis to explore potential metabolic pathways of intestinal fora. Both16S rDNA sequencing and shotgun metagenomic sequencing were conducted on fecal samples.

Results Roseburia were signifcantly reduced in the MHD group based on both 16S rDNA and shotgun metagenomic sequencing analyses. Faecalibacterium, Megamonas, Bifdobacterium, Parabacteroides, Collinsella, Tyzzerella, and Phascolarctobacterium were positively correlated with cognitive function or cognitive domains. Enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways included oxidative phosphorylation, photosynthesis, retrograde endocannabinoid signaling, fagellar assembly, and ribofavin metabolism.

Conclusion Among the microbiota, Roseburia may be important in MHD patients. We demonstrated a correlation between bacterial genera and cognitive function, and propose possible mechanisms.