P-cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease

I. Wen Wu, Kuang Hung Hsu, Chin Chan Lee, Chiao Yin Sun, Heng Jung Hsu, Chi Jen Tsai, Chin Yuan Tzen, Yen Chih Wang, Ching Yuang Lin, Mai Szu Wu

Research output: Contribution to journalArticle

209 Citations (Scopus)

Abstract

Background: Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are uraemic toxins that have similar protein binding, dialytic clearance and proinflammatory features. However, only a few prospective studies have evaluated possible associations between these two retained solutes and renal disease progression in chronic kidney disease (CKD) patients.Methods. This prospective observational study evaluated independent associations between serum total IS and PCS with renal progression in a selected cohort of patients having different stages of CKD. Baseline PCS and IS were correlated with renal progression [defined as decrements in estimated glomerular filtration rate (eGFR) > 50% from baseline or progression to end-stage renal disease (ESRD)] and death during a follow-up period of 24 months.Results. Of 268 patients, 35 (13.1%) had renal progression and 14 (5.2%) died after a mean follow-up of 21 ± 3 months. Univariate Cox regression analysis followed by multivariate analysis showed that high-serum PCS levels were associated with renal progression and all-cause mortality independent of age, gender, diabetes status, albumin levels, serum IS, serum creatinine, Ca × P product, intact parathyroid hormone, haemoglobin or high-sensitivity C-reactive protein level. Serum IS was only associated with renal progression; however, the predictive power of serum IS was weakened when serum PCS was also present in the analytical model.Conclusions. In addition to traditional and uraemia-related risk factors such as renal function, serum IS and PCS levels may help in predicting the risk of renal progression in patients having different stages of CKD.

Original languageEnglish
Pages (from-to)938-947
Number of pages10
JournalNephrology Dialysis Transplantation
Volume26
Issue number3
DOIs
Publication statusPublished - Mar 2011
Externally publishedYes

Fingerprint

Indican
Chronic Renal Insufficiency
Sulfates
Kidney
Serum
Prospective Studies
Uremia
Parathyroid Hormone
Glomerular Filtration Rate
Protein Binding
Serum Albumin
C-Reactive Protein
Chronic Kidney Failure
Observational Studies
Disease Progression
Creatinine
Hemoglobins
Multivariate Analysis
Regression Analysis

Keywords

  • chronic kidney disease
  • indoxyl sulphate
  • p-cresyl sulphate
  • protein-bound toxins
  • proximal tubule

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

P-cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. / Wu, I. Wen; Hsu, Kuang Hung; Lee, Chin Chan; Sun, Chiao Yin; Hsu, Heng Jung; Tsai, Chi Jen; Tzen, Chin Yuan; Wang, Yen Chih; Lin, Ching Yuang; Wu, Mai Szu.

In: Nephrology Dialysis Transplantation, Vol. 26, No. 3, 03.2011, p. 938-947.

Research output: Contribution to journalArticle

Wu, IW, Hsu, KH, Lee, CC, Sun, CY, Hsu, HJ, Tsai, CJ, Tzen, CY, Wang, YC, Lin, CY & Wu, MS 2011, 'P-cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease', Nephrology Dialysis Transplantation, vol. 26, no. 3, pp. 938-947. https://doi.org/10.1093/ndt/gfq580
Wu, I. Wen ; Hsu, Kuang Hung ; Lee, Chin Chan ; Sun, Chiao Yin ; Hsu, Heng Jung ; Tsai, Chi Jen ; Tzen, Chin Yuan ; Wang, Yen Chih ; Lin, Ching Yuang ; Wu, Mai Szu. / P-cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. In: Nephrology Dialysis Transplantation. 2011 ; Vol. 26, No. 3. pp. 938-947.
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AU - Hsu, Kuang Hung

AU - Lee, Chin Chan

AU - Sun, Chiao Yin

AU - Hsu, Heng Jung

AU - Tsai, Chi Jen

AU - Tzen, Chin Yuan

AU - Wang, Yen Chih

AU - Lin, Ching Yuang

AU - Wu, Mai Szu

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N2 - Background: Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are uraemic toxins that have similar protein binding, dialytic clearance and proinflammatory features. However, only a few prospective studies have evaluated possible associations between these two retained solutes and renal disease progression in chronic kidney disease (CKD) patients.Methods. This prospective observational study evaluated independent associations between serum total IS and PCS with renal progression in a selected cohort of patients having different stages of CKD. Baseline PCS and IS were correlated with renal progression [defined as decrements in estimated glomerular filtration rate (eGFR) > 50% from baseline or progression to end-stage renal disease (ESRD)] and death during a follow-up period of 24 months.Results. Of 268 patients, 35 (13.1%) had renal progression and 14 (5.2%) died after a mean follow-up of 21 ± 3 months. Univariate Cox regression analysis followed by multivariate analysis showed that high-serum PCS levels were associated with renal progression and all-cause mortality independent of age, gender, diabetes status, albumin levels, serum IS, serum creatinine, Ca × P product, intact parathyroid hormone, haemoglobin or high-sensitivity C-reactive protein level. Serum IS was only associated with renal progression; however, the predictive power of serum IS was weakened when serum PCS was also present in the analytical model.Conclusions. In addition to traditional and uraemia-related risk factors such as renal function, serum IS and PCS levels may help in predicting the risk of renal progression in patients having different stages of CKD.

AB - Background: Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are uraemic toxins that have similar protein binding, dialytic clearance and proinflammatory features. However, only a few prospective studies have evaluated possible associations between these two retained solutes and renal disease progression in chronic kidney disease (CKD) patients.Methods. This prospective observational study evaluated independent associations between serum total IS and PCS with renal progression in a selected cohort of patients having different stages of CKD. Baseline PCS and IS were correlated with renal progression [defined as decrements in estimated glomerular filtration rate (eGFR) > 50% from baseline or progression to end-stage renal disease (ESRD)] and death during a follow-up period of 24 months.Results. Of 268 patients, 35 (13.1%) had renal progression and 14 (5.2%) died after a mean follow-up of 21 ± 3 months. Univariate Cox regression analysis followed by multivariate analysis showed that high-serum PCS levels were associated with renal progression and all-cause mortality independent of age, gender, diabetes status, albumin levels, serum IS, serum creatinine, Ca × P product, intact parathyroid hormone, haemoglobin or high-sensitivity C-reactive protein level. Serum IS was only associated with renal progression; however, the predictive power of serum IS was weakened when serum PCS was also present in the analytical model.Conclusions. In addition to traditional and uraemia-related risk factors such as renal function, serum IS and PCS levels may help in predicting the risk of renal progression in patients having different stages of CKD.

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KW - p-cresyl sulphate

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