Uremic Toxin Concentrations are Related to Residual Kidney Function in the Pediatric Hemodialysis Population

• Published in: Toxins Vol. 11; no. 4; p. 235
• Main Authors: Snauwaert, Evelien, Holvoet, Els, Van Biesen, Wim, Raes, Ann, Glorieux, Griet, Vande Walle, Johan, Roels, Sanne, Vanholder, Raymond, Askiti, Varvara, Azukaitis, Karolis, Bayazit, Aysun, Canpolat, Nur, Fischbach, Michel, Godefroid, Nathalie, Krid, Saoussen, Litwin, Mieczyslaw, Obrycki, Lukasz, Paglialonga, Fabio, Ranchin, Bruno, Samaille, Charlotte, Schaefer, Franz, Schmitt, Claus Peter, Spasojevic, Brankica, Stefanidis, Constantinos J, Van Dyck, Maria, Van Hoeck, Koen, Collard, Laure, Eloot, Sunny, Shroff, Rukshana
• Format: Journal Article Web Resource
• Language: English
• Published: Switzerland MDPI AG 24.04.2019; MDPI
• Subjects: Acetic acid; Acids; Adolescent; Adults; Age; Child; Child, Preschool; Children; Chronic kidney disease; Correlation coefficient; Correlation coefficients; Dialysis; End-stage kidney disease; Female; Hemodialysis; Hippuric acid; Human health sciences; Humans; Indoleacetic acid; Kidney - metabolism; Kidney - physiopathology; Kidney diseases; Kidneys; Male; Mortality; Patients; Pediatrics; Plasma; Population; Protein Binding; Proteins; Pédiatrie; Quality of life; Renal Dialysis; Renal Insufficiency, Chronic - metabolism; Renal Insufficiency, Chronic - physiopathology; Residual kidney function; Sciences de la santé humaine; Toxins; Toxins, Biological - blood; Toxins, Biological - metabolism; Uremia; Uremic toxins; Uric acid; Urine; Urologie & néphrologie; Urology & nephrology; β2 Microglobulin; hemodialysis; chronic kidney disease; end-stage kidney disease; uremic toxins; residual kidney function; child
• DOI: 10.3390/toxins11040235
• ISSN: 2072-6651

Protein-bound uremic toxins (PBUTs) play a role in the multisystem disease that children on hemodialysis (HD) are facing, but little is known about their levels and protein binding (%PB). In this study, we evaluated the levels and %PB of six PBUTs cross-sectionally in a large pediatric HD cohort ( = 170) by comparing these with healthy and non-dialysis chronic kidney disease (CKD) stage 4-5 ( = 24) children. In parallel β2-microglobulin (β2M) and uric acid (UA) were evaluated. We then explored the impact of age and residual kidney function on uremic toxin levels and %PB using analysis of covariance and Spearman correlation coefficients ( ). We found higher levels of β2M, p-cresyl glucuronide (pCG), hippuric acid (HA), indole acetic acid (IAA), and indoxyl sulfate (IxS) in the HD compared to the CKD4-5 group. In the HD group, a positive correlation between age and pCG, HA, IxS, and pCS levels was shown. Residual urine volume was negatively correlated with levels of β2M, pCG, HA, IAA, IxS, and CMPF ( -0.2 to -0.5). In addition, we found overall lower %PB of PBUTs in HD versus the CKD4-5 group, and showed an age-dependent increase in %PB of IAA, IxS, and pCS. Furhtermore, residual kidney function was overall positively correlated with %PB of PBUTs. In conclusion, residual kidney function and age contribute to PBUT levels and %PB in the pediatric HD population.