Serum free p-cresyl sulfate levels predict cardiovascular and all-cause mortality in elderly hemodialysis patients-A prospective cohort study

I. Wen Wu, Kuang Hung Hsu, Heng Jung Hsu, Chin Chan Lee, Chiao Yin Sun, Chi Jen Tsai, Mai Szu Wu

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116 Citations (Scopus)


Background. The mortality rate of elderly hemodialysis (HD) patients is high. Serum p-cresyl sulfate (PCS) and indoxyl sulfate (IS) are associated with cardiovascular (CV) disease and mortality in renal patients. The association between such biomarkers and mortality in elderly HD patients has a high clinical value but remains unclear. Methods. This prospective cohort study investigated the association of serum IS and PCS with all-cause and CV mortality in elderly HD patients. Multivariate Cox regression analysis was used to estimate the risk of all-cause and CV mortality in this prospective cohort. Results. Of 112 patients, 45 deaths (18 CV deaths) were identified after a mean follow-up of 33.2 months. The cumulative and CV survival of patients with lower free PCS was significantly better than high free PCS patients. In multivariate Cox regression analysis, serum free PCS was associated with all-cause and CV mortality after various adjustments, including age, gender and diabetes status (Model 1), albumin (Model 2), Ca 3 P product and intact parathyroid hormone (Model 3), hemoglobin and high-sensitivity C-reactive protein (Model 4) and hierarchically selected covariates (age, diabetes status and albumin, Model 5). Conclusion. Serum free PCS levels may help in predicting risk of all-cause and CV mortality in elderly HD patients beyond traditional and uremia related risk factors.

Original languageEnglish
Pages (from-to)1169-1175
Number of pages7
JournalNephrology Dialysis Transplantation
Issue number3
Publication statusPublished - May 2012
Externally publishedYes



  • Elderly
  • Hemodialysis
  • Indoxyl sulfate
  • Mortality
  • P-cresyl sulfate

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

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