The Association between Serum Indoxyl Sulfate, P-Cresyl Sulfate and Cardiovascular Risk Factors in Peritoneal Dialysis Patients
Journal of Nephrology & Therapeutics(2021)
摘要
Background: Indoxyl Sulfate (IS) and p-Cresol Sulfate (pCS) are two important gut-derived uremic toxins accumulated in patients with Chronic Kidney Disease
(CKD). They have been reported contributing greatly to Cardiovascular Disease (CVD) both in epidemiological studies and animal models. The present study was
conducted to explore whether IS and pCS contribute to CVD by accelerating cardiovascular risk factors in Peritoneal Dialysis (PD) patients.
Methods: A cross-sectional study was conducted on 119 PD patients. Serum IS and pCS were measured by Ultra-High-Performance LC–tandem MS (UPLCMS/
MS), and metabolic parameters involved in cardiovascular risk were measured by auto-biochemistry analyzer machine. Univariate and multivariate linear
regression models were performed to determine the association between the independent variables (IS and pCS) and clinical indexes. Multivariable-adjusted
logistic regression models were used to estimate the odds ratios (ORs, 95% confidence intervals (CIs)).
Results: The median BMI of PD patients was 20.10 (18.95, 22.90) kg/m2. The median serum IS and pCS concentrations were 22.46 (13.45, 29.92) mg/L
and 12.41 (5.29, 24.45) mg/L, respectively. Positive significant associations were observed between serum IS concentration and PD duration, creatinine, prealbumin,
phosphorus, magnesium and β2-microglobulin (β2-m) with the corresponding correlation coefficient r and p value of 0.22 (P=0.020), 0.48 (P<0.001),
0.32 (P<0.001), 0.34 (P<0.001), 0.28 (P=0.002), 0.50 (P<0.001). Also, statistically negative significant associations were observed between IS and estimated
Glomerular Filtration Rate (eGFR)-0.46 (P<0.001). Besides, a significant positive association between pCS and albumin 0.32 (P<0.001) was indicated.
Conclusions: Serum clinical indexes were dependent cardiovascular risk factors for increasing IS and pCS levels, which contribute to CVD in peritoneal dialysis
patients. Mechanism research should be conducted in the future to explore causality.
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关键词
serum indoxyl sulfate,peritoneal dialysis,cardiovascular risk factors,p-cresyl
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