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Association between protein-bound uremic toxins and asymptomatic cardiac dysfunction in patients with chronic kidney disease

(2018) TOXINS. 10(12).
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Abstract
Although the relationship between protein-bound uremic toxins (PBUTs) and cardiac structure and cardiac mortality in chronic kidney disease (CKD) has been studied in the past, the association between cardiac dysfunction and PBUTs has not yet been studied. We therefore evaluated the association between impaired peak cardiac performance and the serum free and total concentrations of potentially cardiotoxic PBUTs. In a cross-sectional study of 56 male CKD patients (stages 2⁻5 (pre-dialysis)) who were asymptomatic with no known cardiac diseases or diabetes we measured peak cardiac power (CPOmax), aerobic exercise capacity (VO2max), and echocardiographic parameters of cardiac morphology and evaluated their association with PBUTs. The serum total and free concentrations of indoxyl sulfate (IXS), p-cresyl sulfate (PCS), p-cresyl glucuronide, indole acetic acid, and hippuric acid showed significant negative correlation with CPOmax and VO2max. IXS and PCS were independently associated with CPOmax and VO2max even after controlling for eGFR. No correlation between left ventricular mass index (LVMI) and PBUTs was seen. The present study for the first time has demonstrated the association between subclinical cardiac dysfunction in CKD and serum levels of a panel of PBUTs. Further studies are required to evaluate the mechanism of cardiotoxicity of the individual uremic toxins.
Keywords
uremic toxins, cardiac function, cardiac power, aerobic exercise capacity, INDOXYL SULFATE, OXIDATIVE STRESS, P-CRESYLSULPHATE, HEART-FAILURE, POWER OUTPUT, HYPERTROPHY, PROGNOSIS

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Chicago
Chinnappa, Shanmugakumar, Yu-Kang Tu, Yi Chun Yeh, Griet Glorieux, Raymond Vanholder, and Andrew Mooney. 2018. “Association Between Protein-bound Uremic Toxins and Asymptomatic Cardiac Dysfunction in Patients with Chronic Kidney Disease.” Toxins 10 (12).
APA
Chinnappa, S., Tu, Y.-K., Yeh, Y. C., Glorieux, G., Vanholder, R., & Mooney, A. (2018). Association between protein-bound uremic toxins and asymptomatic cardiac dysfunction in patients with chronic kidney disease. TOXINS, 10(12).
Vancouver
1.
Chinnappa S, Tu Y-K, Yeh YC, Glorieux G, Vanholder R, Mooney A. Association between protein-bound uremic toxins and asymptomatic cardiac dysfunction in patients with chronic kidney disease. TOXINS. 2018;10(12).
MLA
Chinnappa, Shanmugakumar et al. “Association Between Protein-bound Uremic Toxins and Asymptomatic Cardiac Dysfunction in Patients with Chronic Kidney Disease.” TOXINS 10.12 (2018): n. pag. Print.
@article{8586979,
  abstract     = {Although the relationship between protein-bound uremic toxins (PBUTs) and cardiac structure and cardiac mortality in chronic kidney disease (CKD) has been studied in the past, the association between cardiac dysfunction and PBUTs has not yet been studied. We therefore evaluated the association between impaired peak cardiac performance and the serum free and total concentrations of potentially cardiotoxic PBUTs. In a cross-sectional study of 56 male CKD patients (stages 2⁻5 (pre-dialysis)) who were asymptomatic with no known cardiac diseases or diabetes we measured peak cardiac power (CPOmax), aerobic exercise capacity (VO2max), and echocardiographic parameters of cardiac morphology and evaluated their association with PBUTs. The serum total and free concentrations of indoxyl sulfate (IXS), p-cresyl sulfate (PCS), p-cresyl glucuronide, indole acetic acid, and hippuric acid showed significant negative correlation with CPOmax and VO2max. IXS and PCS were independently associated with CPOmax and VO2max even after controlling for eGFR. No correlation between left ventricular mass index (LVMI) and PBUTs was seen. The present study for the first time has demonstrated the association between subclinical cardiac dysfunction in CKD and serum levels of a panel of PBUTs. Further studies are required to evaluate the mechanism of cardiotoxicity of the individual uremic toxins.},
  articleno    = {520},
  author       = {Chinnappa, Shanmugakumar and Tu, Yu-Kang and Yeh, Yi Chun and Glorieux, Griet and Vanholder, Raymond and Mooney, Andrew},
  issn         = {2072-6651},
  journal      = {TOXINS},
  keywords     = {uremic toxins,cardiac function,cardiac power,aerobic exercise capacity,INDOXYL SULFATE,OXIDATIVE STRESS,P-CRESYLSULPHATE,HEART-FAILURE,POWER OUTPUT,HYPERTROPHY,PROGNOSIS},
  language     = {eng},
  number       = {12},
  pages        = {13},
  title        = {Association between protein-bound uremic toxins and asymptomatic cardiac dysfunction in patients with chronic kidney disease},
  url          = {http://dx.doi.org/10.3390/toxins10120520},
  volume       = {10},
  year         = {2018},
}

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