Document Detail

Factors associated with blood concentrations of indoxyl sulfate and p-cresol in patients undergoing peritoneal dialysis.
MedLine Citation:
PMID:  20338972     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Accumulating evidence supports the important role of protein-bound uremic toxins such as indoxyl sulfate and p-cresol in uremic syndrome. They exert direct deleterious effects on a variety of cells and could link to clinical outcome. Factors relevant to indoxyl sulfate and p-cresol levels in peritoneal dialysis (PD) patients have rarely been investigated. We conducted a cross-sectional study to analyze the factors that correlate with both total and free indoxyl sulfate and p-cresol.
METHODS: 182 stable PD patients with mean PD therapy duration 38.5 +/- 33.3 months were enrolled. Their mean age was 48.9 +/- 13.5 years; 62.6% (114/182) were female patients. Demographic data, including age, gender, and PD therapy duration, were reviewed and recorded. PD-associated features such as residual kidney function (RKF), peritoneal transport property, and dialysis modality were also recorded. Hemoglobin, blood urea nitrogen (BUN), serum creatinine, C-reactive protein, interleukin (IL)-6, and IL-10 were measured. Levels of total and free indoxyl sulfate and p-cresol were determined.
RESULTS: Patients without RKF had lower Kt/V and weekly creatinine clearance and higher serum creatinine and IL-6 levels. These patients also had higher total and free indoxyl sulfate levels. There was no difference in indoxyl sulfate or p-cresol levels compared to patients with different peritoneal transport properties or with different treatment modalities. Multivariate regression analysis revealed that weekly creatinine clearance and serum creatinine were independent associates of total indoxyl sulfate level; IL-6, total indoxyl sulfate, and free p-cresol were associated with free indoxyl sulfate level. Weekly creatinine clearance and free p-cresol level independently correlated with total p-cresol; while gender, total p-cresol, and free indoxyl sulfate were associated with free p-cresol level.
CONCLUSION: The free forms of indoxyl sulfate and p-cresol constituted a small portion of their total forms. The presence of RKF affected levels of free and total indoxyl sulfate. IL-6 level was significantly associated with free indoxyl sulfate level. There was a close relationship between indoxyl sulfate and p-cresol levels in their free forms in PD patients.
Chien-Te Lee; Chien-Chun Kuo; Yu-Ming Chen; Chung-Yao Hsu; Wen-Chin Lee; Yu-Che Tsai; Hwee-Yeong Ng; Li-Chueh Kuo; Terry Ting-Yu Chiou; Yu-Kun Yang; Ben-Chung Cheng; Jin-Bor Chen
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-25
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  30     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-07-14     Completed Date:  2012-02-10     Revised Date:  2012-08-08    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  456-63     Citation Subset:  IM    
Division of Nephrology, Chang-Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
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MeSH Terms
Cresols / blood*
Cross-Sectional Studies
Indican / blood*
Interleukin-6 / blood*
Middle Aged
Peritoneal Dialysis*
Uremia / blood*,  therapy
Reg. No./Substance:
0/Cresols; 0/Interleukin-6; 106-44-5/4-cresol; 487-94-5/Indican

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