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Free p-cresylsulphate is a predictor of mortality in patients at different stages of chronic kidney disease

Sophie Liabeuf, Daniela V Barreto, Fellype C Barreto, Natalie Meert, Griet Glorieux UGent, Eva Schepers, Mohammed Temmar, Gabriel Choukroun, Raymond Vanholder UGent and Ziad A Massy (2010) NEPHROLOGY DIALYSIS TRANSPLANTATION. 25(4). p.1183-1191
abstract
Background. Uraemic toxins are considered to be emerging mortality risk factors in chronic kidney disease (CKD) patients. p-Cresol (a prototype protein-bound uraemic retention solute) has been shown to exert toxic effects in vitro. Recently, it has been demonstrated that p-cresol is present in plasma as its sulphate conjugate, p-cresylsulphate. The present study evaluated the distribution of free and total p-cresylsulphate and sought to determine whether these parameters were associated with vascular calcification, arterial stiffness and mortality risk in a cohort of CKD patients. Methods. One hundred and thirty-nine patients (mean SD age: 67 +/- 12; males: 60%) at different stages of CKD (8% at Stage 2, 26.5% at Stage 3, 26.5% at Stage 4, 7% at Stage 5 and 32% at Stage 5D) were enrolled in this study. Results. Baseline total and free p-cresylsulphate presented an inverse relationship with renal function and were significantly associated with vascular calcification. During the study period (mean follow-up period: 779 +/- 185 days), 38 patients died [including 22 from cardiovascular (CV) causes]. In crude survival analyses, free (but not total) p-cresylsulphate was shown to be a predictor of overall and CV death. Higher free p-cresylsulphate levels (>0.051 mg/100 mL; median) were associated with mortality independently of well-known predictors of survival such as age, vascular calcification, anaemia and inflammation. Conclusions. Serum levels of free and total p-cresylsulphate (the main in vivo circulating metabolites of p-cresol) were elevated in later CKD stages. However, only free p-cresylsulphate seems to be a predictor of survival in CKD.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
TOXICITY, HEMODIALYSIS-PATIENTS, SERUM CONCENTRATIONS, RETENTION SOLUTE, CRESOL, UREMIC SOLUTES, AST-120, REMOVAL, SULFATE, cardiovascular disease, mortality, p-cresylsulphate, chronic kidney disease, Uraemic toxins, CARDIOVASCULAR-DISEASE
journal title
NEPHROLOGY DIALYSIS TRANSPLANTATION
Nephrol. Dial. Transplant.
volume
25
issue
4
pages
1183 - 1191
Web of Science type
Article
Web of Science id
000277279400027
JCR category
UROLOGY & NEPHROLOGY
JCR impact factor
3.564 (2010)
JCR rank
12/68 (2010)
JCR quartile
1 (2010)
ISSN
0931-0509
DOI
10.1093/ndt/gfp592
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1068912
handle
http://hdl.handle.net/1854/LU-1068912
date created
2010-11-03 09:59:59
date last changed
2016-12-19 15:46:27
@article{1068912,
  abstract     = {Background. Uraemic toxins are considered to be emerging mortality risk factors in chronic kidney disease (CKD) patients. p-Cresol (a prototype protein-bound uraemic retention solute) has been shown to exert toxic effects in vitro. Recently, it has been demonstrated that p-cresol is present in plasma as its sulphate conjugate, p-cresylsulphate. The present study evaluated the distribution of free and total p-cresylsulphate and sought to determine whether these parameters were associated with vascular calcification, arterial stiffness and mortality risk in a cohort of CKD patients.
Methods. One hundred and thirty-nine patients (mean SD age: 67 +/- 12; males: 60\%) at different stages of CKD (8\% at Stage 2, 26.5\% at Stage 3, 26.5\% at Stage 4, 7\% at Stage 5 and 32\% at Stage 5D) were enrolled in this study.
Results. Baseline total and free p-cresylsulphate presented an inverse relationship with renal function and were significantly associated with vascular calcification. During the study period (mean follow-up period: 779 +/- 185 days), 38 patients died [including 22 from cardiovascular (CV) causes]. In crude survival analyses, free (but not total) p-cresylsulphate was shown to be a predictor of overall and CV death. Higher free p-cresylsulphate levels ({\textrangle}0.051 mg/100 mL; median) were associated with mortality independently of well-known predictors of survival such as age, vascular calcification, anaemia and inflammation.
Conclusions. Serum levels of free and total p-cresylsulphate (the main in vivo circulating metabolites of p-cresol) were elevated in later CKD stages. However, only free p-cresylsulphate seems to be a predictor of survival in CKD.},
  author       = {Liabeuf, Sophie and Barreto, Daniela V and Barreto, Fellype C and Meert, Natalie and Glorieux, Griet and Schepers, Eva and Temmar, Mohammed and Choukroun, Gabriel and Vanholder, Raymond and Massy, Ziad A},
  issn         = {0931-0509},
  journal      = {NEPHROLOGY DIALYSIS TRANSPLANTATION},
  keyword      = {TOXICITY,HEMODIALYSIS-PATIENTS,SERUM CONCENTRATIONS,RETENTION SOLUTE,CRESOL,UREMIC SOLUTES,AST-120,REMOVAL,SULFATE,cardiovascular disease,mortality,p-cresylsulphate,chronic kidney disease,Uraemic toxins,CARDIOVASCULAR-DISEASE},
  language     = {eng},
  number       = {4},
  pages        = {1183--1191},
  title        = {Free p-cresylsulphate is a predictor of mortality in patients at different stages of chronic kidney disease},
  url          = {http://dx.doi.org/10.1093/ndt/gfp592},
  volume       = {25},
  year         = {2010},
}

Chicago
Liabeuf, Sophie, Daniela V Barreto, Fellype C Barreto, Natalie Meert, Griet Glorieux, Eva Schepers, Mohammed Temmar, Gabriel Choukroun, Raymond Vanholder, and Ziad A Massy. 2010. “Free P-cresylsulphate Is a Predictor of Mortality in Patients at Different Stages of Chronic Kidney Disease.” Nephrology Dialysis Transplantation 25 (4): 1183–1191.
APA
Liabeuf, S., Barreto, D. V., Barreto, F. C., Meert, N., Glorieux, G., Schepers, E., Temmar, M., et al. (2010). Free p-cresylsulphate is a predictor of mortality in patients at different stages of chronic kidney disease. NEPHROLOGY DIALYSIS TRANSPLANTATION, 25(4), 1183–1191.
Vancouver
1.
Liabeuf S, Barreto DV, Barreto FC, Meert N, Glorieux G, Schepers E, et al. Free p-cresylsulphate is a predictor of mortality in patients at different stages of chronic kidney disease. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2010;25(4):1183–91.
MLA
Liabeuf, Sophie, Daniela V Barreto, Fellype C Barreto, et al. “Free P-cresylsulphate Is a Predictor of Mortality in Patients at Different Stages of Chronic Kidney Disease.” NEPHROLOGY DIALYSIS TRANSPLANTATION 25.4 (2010): 1183–1191. Print.