Serum Total p -Cresol and Indoxyl Sulfate Correlated With Stage of Chronic Kidney Disease in Renal Transplant Recipients

• Published in: Transplantation proceedings Vol. 44; no. 3; pp. 621 - 624
• Main Authors: Huang, S.-T, Shu, K.-H, Cheng, C.-H, Wu, M.-J, Yu, T.-M, Chuang, Y.-W, Chen, C.-H
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.04.2012; Elsevier
• Subjects: Adult; Biological and medical sciences; Cresols - blood; Disease Progression; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Indican - blood; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - pathology; Kidney Failure, Chronic - surgery; Kidney Transplantation; Kidneys; Male; Medical sciences; Nephrology. Urinary tract diseases; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Urinary system involvement in other diseases. Miscellaneous; Kidney disease; Urinary system disease; Chronic kidney disease; Transplantation; Homotransplantation; Sulfates; Kidney; Medicine; Clinical stage; Treatment; Urinary system; Surgery; Renal failure; Total; Graft; Serum
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.11.023

Abstract Background Uremic toxins are considered cardiovascular and mortality risk factors in chronic kidney disease (CKD) patients. Both p -cresol and indoxyl sulfate have been shown to induce oxidative stress in vitro and subsequent endothelial dysfunction in uremic patients. Our study evaluated the levels of p -cresol and indoxyl sulfate, and whether they contribute to the progression of CKD in transplant recipients. Methods We retrospectively evaluated 95 patients who had received a transplant from February 1987 to June 2010 in our center; the recipients had a mean transplant duration of 5.3 ± 4.9 years and a mean age of 47.8 ± 14.1 years. Among them, 56.8% (54/95) were male. Patients with glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m2 were selected for group 1 (n = 35), and those with GFR < 60 mL/min/1.73 m2 were selected for group 2 (n = 60). Demographic and clinical data were compared between groups. Serum and urine levels of p -cresol and indoxyl sulfate were also obtained. Results Baseline serum p -cresol and indoxyl sulfate levels were significantly higher in advanced CKD stages ( P = .001 and <.0001, respectively). Patients at advanced CKD stages (group 2) had lower serum levels of hemoglobin and albumin ( P < .0001), but higher levels of total cholesterol, triglyceride, and uric acid levels ( P = .04, .04 and .001, respectively). Body mass index, C-reactive protein, and serum calcium and phosphate levels showed no significant differences between groups. The cut-off value for serum p -cresol between groups was 1.28 umol/L ( P = .01), and that for the indoxyl sulfate level was 0.98 umol/L ( P = .0001). Conclusion The serum p -cresol and indoxyl sulfate levels were significantly higher in advanced CKD stages in transplant recipients. To evaluate the use of serum p -cresol and indoxyl sulfate levels as a predictive tool for survival, larger clinical studies are needed.