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Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population

Evelien Snauwaert (UGent) , Els Holvoet (UGent) , Wim Van Biesen (UGent) , Ann Raes (UGent) , Griet Glorieux (UGent) , Johan Vande Walle (UGent) , Sanne Roels (UGent) , Raymond Vanholder (UGent) , Varvara Askiti, Karolis Azukaitis, et al.
(2019) TOXINS. 11(4).
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Organization
Abstract
Protein-bound uremic toxins (PBUTs) play a role in the multisystem disease that children on hemodialysis (HD) are facing, but little is known about their levels and protein binding (%PB). In this study, we evaluated the levels and %PB of six PBUTs cross-sectionally in a large pediatric HD cohort (n = 170) by comparing these with healthy and non-dialysis chronic kidney disease (CKD) stage 4-5 (n = 24) children. In parallel 2-microglobulin (2M) and uric acid (UA) were evaluated. We then explored the impact of age and residual kidney function on uremic toxin levels and %PB using analysis of covariance and Spearman correlation coefficients (r(s)). We found higher levels of 2M, p-cresyl glucuronide (pCG), hippuric acid (HA), indole acetic acid (IAA), and indoxyl sulfate (IxS) in the HD compared to the CKD4-5 group. In the HD group, a positive correlation between age and pCG, HA, IxS, and pCS levels was shown. Residual urine volume was negatively correlated with levels of 2M, pCG, HA, IAA, IxS, and CMPF (r(s) -0.2 to -0.5). In addition, we found overall lower %PB of PBUTs in HD versus the CKD4-5 group, and showed an age-dependent increase in %PB of IAA, IxS, and pCS. Furhtermore, residual kidney function was overall positively correlated with %PB of PBUTs. In conclusion, residual kidney function and age contribute to PBUT levels and %PB in the pediatric HD population.
Keywords
PROTEIN-BOUND SOLUTES, PERITONEAL-DIALYSIS, RENAL-FUNCTION, SERUM, CONCENTRATIONS, ALBUMIN-BINDING, INDOXYL SULFATE, CHILDREN, ACCUMULATION, MORTALITY, RISK, chronic kidney disease, end-stage kidney disease, child, uremic toxins, hemodialysis, residual kidney function

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Chicago
Snauwaert, Evelien, Els Holvoet, Wim Van Biesen, Ann Raes, Griet Glorieux, Johan Vande Walle, Sanne Roels, et al. 2019. “Uremic Toxin Concentrations Are Related to Residual Kidney Function in the Pediatric Hemodialysis Population.” Toxins 11 (4).
APA
Snauwaert, E., Holvoet, E., Van Biesen, W., Raes, A., Glorieux, G., Vande Walle, J., Roels, S., et al. (2019). Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population. TOXINS, 11(4).
Vancouver
1.
Snauwaert E, Holvoet E, Van Biesen W, Raes A, Glorieux G, Vande Walle J, et al. Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population. TOXINS. 2019;11(4).
MLA
Snauwaert, Evelien et al. “Uremic Toxin Concentrations Are Related to Residual Kidney Function in the Pediatric Hemodialysis Population.” TOXINS 11.4 (2019): n. pag. Print.
@article{8622015,
  abstract     = {Protein-bound uremic toxins (PBUTs) play a role in the multisystem disease that children on hemodialysis (HD) are facing, but little is known about their levels and protein binding (%PB). In this study, we evaluated the levels and %PB of six PBUTs cross-sectionally in a large pediatric HD cohort (n = 170) by comparing these with healthy and non-dialysis chronic kidney disease (CKD) stage 4-5 (n = 24) children. In parallel 2-microglobulin (2M) and uric acid (UA) were evaluated. We then explored the impact of age and residual kidney function on uremic toxin levels and %PB using analysis of covariance and Spearman correlation coefficients (r(s)). We found higher levels of 2M, p-cresyl glucuronide (pCG), hippuric acid (HA), indole acetic acid (IAA), and indoxyl sulfate (IxS) in the HD compared to the CKD4-5 group. In the HD group, a positive correlation between age and pCG, HA, IxS, and pCS levels was shown. Residual urine volume was negatively correlated with levels of 2M, pCG, HA, IAA, IxS, and CMPF (r(s) -0.2 to -0.5). In addition, we found overall lower %PB of PBUTs in HD versus the CKD4-5 group, and showed an age-dependent increase in %PB of IAA, IxS, and pCS. Furhtermore, residual kidney function was overall positively correlated with %PB of PBUTs. In conclusion, residual kidney function and age contribute to PBUT levels and %PB in the pediatric HD population.},
  articleno    = {235},
  author       = {Snauwaert, Evelien and Holvoet, Els and Van Biesen, Wim and Raes, Ann and Glorieux, Griet and Vande Walle, Johan and Roels, Sanne and Vanholder, Raymond and Askiti, Varvara and Azukaitis, Karolis and Bayazit, Aysun and Canpolat, Nur and Fischbach, Michel and Godefroid, Nathalie and Krid, Saoussen and Litwin, Mieczyslaw and Obrycki, Lukasz and Paglialonga, Fabio and Ranchin, Bruno and Samaille, Charlotte and Schaefer, Franz and Schmitt, Claus Peter and Spasojevic, Brankica and Stefanidis, Constantinos J and Van Dyck, Maria and Van Hoeck, Koen and Collard, Laure and Eloot, Sunny and Shroff, Rukshana},
  issn         = {2072-6651},
  journal      = {TOXINS},
  keywords     = {PROTEIN-BOUND SOLUTES,PERITONEAL-DIALYSIS,RENAL-FUNCTION,SERUM,CONCENTRATIONS,ALBUMIN-BINDING,INDOXYL SULFATE,CHILDREN,ACCUMULATION,MORTALITY,RISK,chronic kidney disease,end-stage kidney disease,child,uremic toxins,hemodialysis,residual kidney function},
  language     = {eng},
  number       = {4},
  pages        = {15},
  title        = {Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population},
  url          = {http://dx.doi.org/10.3390/toxins11040235},
  volume       = {11},
  year         = {2019},
}

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