Figure 6
Proposed model of the relationship between oral Streptococcus-derived d-alanine (D-Ala) and kidney disease. d-Serine (D-Ser) and D-Ala were present in the blood and urine of healthy controls. Plasma D-Ser levels were higher, whereas urine D-Ser levels were lower in all patients with CKD than in healthy controls. However, the abundances of oral Streptococcus species and plasma D-Ala levels were higher in patients with CKD and DM than in those without DM. In addition, salivary D/L-Ala and plasma D-Ala levels were associated with positive estimated glomerular filtration rate slopes in patients with CKD and DM. CKD chronic kidney disease, DM diabetes mellitus.
