The association of uremic toxins and inflammation in hemodialysis patients.

Abstract

BACKGROUND:

Cardiovascular disease is the leading cause of mortality in hemodialysis patients and is associated with chronic inflammation. Elevation of uremic toxins, particular protein-bound uremic toxins, is a possible cause of hyper-inflammation in hemodialysis patients. But the association between uremic toxins and inflammatory markers in hemodialysis is still unclear.

METHODS:

We conducted a cross-sectional study to evaluate the association of the serum uremic toxins and inflammatory markers in hemodialysis patients.

RESULTS:

The uremic toxins were not associated with inflammatory markers--including high sensitivity C-reactive protein, IL(Interleukin) -1β, IL-6, tumor necrosis factor-α. In multiple linear regression, serum levels of total p-cresol sulfate (PCS) were independently significantly associated with serum total indoxyl sulfate (IS) (standardized coefficient: 0.274, p<0.001), and co-morbidity of diabetes mellitus (DM) (standardized coefficient: 0.342, p<0.001) and coronary artery disease (CAD) (standardized coefficient: 0.128, p = 0.043). The serum total PCS levels in hemodialysis with co-morbidity of DM and CAD were significantly higher than those without co-morbidity of DM and CAD (34.10±23.44 vs. 16.36±13.06 mg/L, p<0.001). Serum levels of total IS was independently significantly associated with serum creatinine (standardized coefficient: 0.285, p<0.001), total PCS (standardized coefficient: 0.239, p = 0.001), and synthetic membrane dialysis (standardized coefficient: 0.139, p = 0.046).

CONCLUSION:

The study showed that serum levels of total PCS and IS were not associated with pro-inflammatory markers in hemodialysis patients. Besides, serum levels of total PCS were independently positively significantly associated with co-morbidity of CAD and DM.

• Authors: Heng-Jung Hsu, Chiung-Hui Yen, I-Wen Wu, Kuang-Hung Hsu, Chih-Ken Chen, Chiao-Yin Sun, Chia-Chi Chou, Chun-Yu Chen, Chi-Jen Tsai, Mai-Szu Wu, Chin-Chan Lee
• Journal: PloS one (PLoS One) Vol. 9 Issue 7 Pg. e102691 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 25051062 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cresols
• Inflammation Mediators
• Sulfuric Acid Esters
• 4-cresol sulfate
• Creatinine
• Indican

Topics

• Aged
• Comorbidity
• Coronary Artery Disease (blood, epidemiology)
• Creatinine (blood)
• Cresols (blood)
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (blood, epidemiology)
• Female
• Humans
• Indican (blood)
• Inflammation (blood)
• Inflammation Mediators (blood)
• Kidney Failure, Chronic (blood, epidemiology, therapy)
• Male
• Middle Aged
• Renal Dialysis
• Sulfuric Acid Esters (blood)