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Association between indoxyl sulfate and bone histomorphometry in pre-dialysis chronic kidney disease patients

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Abstract
Introduction: Experimental studies have suggested that indoxyl sulfate (IS), a protein-bound uremic toxin, may be involved in the development of renal osteodystrophy. Objective: evaluate the association between IS levels and biochemical parameters related to mineral metabolism and bone histomorphometry in a cohort of pre-dialysis chronic kidney disease (CKD) patients. Methods: This is a post-hoc analysis of an observational study evaluating the association between coronary calcification and bone biopsy findings in 49 patients (age: 52 ± 10 years; 67% male; estimated glomerular filtration rate: 36 ± 17 ml/min). Serum levels of IS were measured. Results: Patients at CKD stages 2 and 3 presented remarkably low bone formation rate. Patients at CKD stages 4 and 5 presented significantly higher osteoid volume, osteoblast and osteoclast surface, bone fibrosis volume and bone formation rate and a lower mineralization lag time than CKD stage 2 and 3 patients. We observed a positive association between IS levels on one hand and the bone formation rate, osteoid volume, osteoblast surface and bone fibrosis volume on the other. Multivariate regression models confirmed that the associations between IS levels and osteoblast surface and bone fibrosis volume were both independent of demographic and biochemical characteristics of the study population. A similar trend was observed for the bone formation rate. Conclusions: Our findings demonstrated that IS is positively associated with bone formation rate in pre-dialysis CKD patients.
Keywords
renal osteodystrophy, uremia, indoxyl sulfate, renal insufficiency, chronic

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Chicago
Barreto, Fellype Carvalho, Daniela Veit Barreto, Maria Eugênia Fernandes Canziani, Cristianne Tomiyama, Andrea Higa, Anaïs Mozar, Griet Glorieux, Raymond Vanholder, Ziad Massy, and Aluizio Barbosa de Carvalho. 2014. “Association Between Indoxyl Sulfate and Bone Histomorphometry in Pre-dialysis Chronic Kidney Disease Patients.” Jornal Brasileiro De Nefrologia 36 (3): 289–296.
APA
Barreto, F. C., Barreto, D. V., Canziani, M. E. F., Tomiyama, C., Higa, A., Mozar, A., Glorieux, G., et al. (2014). Association between indoxyl sulfate and bone histomorphometry in pre-dialysis chronic kidney disease patients. JORNAL BRASILEIRO DE NEFROLOGIA, 36(3), 289–296.
Vancouver
1.
Barreto FC, Barreto DV, Canziani MEF, Tomiyama C, Higa A, Mozar A, et al. Association between indoxyl sulfate and bone histomorphometry in pre-dialysis chronic kidney disease patients. JORNAL BRASILEIRO DE NEFROLOGIA. 2014;36(3):289–96.
MLA
Barreto, Fellype Carvalho, Daniela Veit Barreto, Maria Eugênia Fernandes Canziani, et al. “Association Between Indoxyl Sulfate and Bone Histomorphometry in Pre-dialysis Chronic Kidney Disease Patients.” JORNAL BRASILEIRO DE NEFROLOGIA 36.3 (2014): 289–296. Print.
@article{5866721,
  abstract     = {Introduction: Experimental studies have suggested that indoxyl sulfate (IS), a protein-bound uremic toxin, may be involved in the development of renal osteodystrophy.
Objective: evaluate the association between IS levels and biochemical parameters related to mineral metabolism and bone histomorphometry in a cohort of pre-dialysis chronic kidney disease (CKD) patients.
Methods: This is a post-hoc analysis of an observational study evaluating the association between coronary calcification and bone biopsy findings in 49 patients (age: 52 {\textpm} 10 years; 67\% male; estimated glomerular filtration rate: 36 {\textpm} 17 ml/min). Serum levels of IS were measured.
Results: Patients at CKD stages 2 and 3 presented remarkably low bone formation rate. Patients at CKD stages 4 and 5 presented significantly higher osteoid volume, osteoblast and osteoclast surface, bone fibrosis volume and bone formation rate and a lower mineralization lag time than CKD stage 2 and 3 patients. We observed a positive association between IS levels on one hand and the bone formation rate, osteoid volume, osteoblast surface and bone fibrosis volume on the other. Multivariate regression models confirmed that the associations between IS levels and osteoblast surface and bone fibrosis volume were both independent of demographic and biochemical characteristics of the study population. A similar trend was observed for the bone formation rate.
Conclusions: Our findings demonstrated that IS is positively associated with bone formation rate in pre-dialysis CKD patients.},
  author       = {Barreto, Fellype Carvalho and Barreto, Daniela Veit and Canziani, Maria Eug{\^e}nia Fernandes and Tomiyama, Cristianne and Higa, Andrea and Mozar, Ana{\"i}s and Glorieux, Griet and Vanholder, Raymond and Massy, Ziad and de Carvalho, Aluizio Barbosa},
  issn         = {0101-2800},
  journal      = {JORNAL BRASILEIRO DE NEFROLOGIA},
  keyword      = {renal osteodystrophy,uremia,indoxyl sulfate,renal insufficiency,chronic},
  language     = {eng},
  number       = {3},
  pages        = {289--296},
  title        = {Association between indoxyl sulfate and bone histomorphometry in pre-dialysis chronic kidney disease patients},
  url          = {http://dx.doi.org/10.5935/0101-2800.20140042},
  volume       = {36},
  year         = {2014},
}

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