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p-Cresol and cardiovascular risk in mild-to-moderate kidney disease

Björn K I Meijers1, Kathleen Claes, Bert Bammens

  • 1Department of Medicine, Division of Nephrology and Laboratory for Gastro-Intestinal Research and Leuven Food Science and Nutrition Research Centre (LFoRCe), University Hospital Leuven, Leuven, Belgium.

Clinical Journal of the American Society of Nephrology : CJASN
|May 1, 2010
PubMed

Insights

High free p-cresol levels predict cardiovascular events in chronic kidney disease (CKD) patients not yet on dialysis. This finding suggests p-cresol may be a novel risk marker for cardiovascular disease in CKD.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Cardiovascular disease (CVD) is common in chronic kidney disease (CKD).
  • Traditional CVD risk factors do not fully explain this high prevalence.
  • Free p-cresol, a derivative of p-cresyl sulfate, is linked to CVD in dialysis patients.

Purpose of the Study:

  • To investigate the association between free p-cresol serum concentrations and cardiovascular events in patients with CKD not yet on dialysis.
  • To determine if p-cresol is an independent predictor of CVD in this population.

Main Methods:

  • Prospective observational study of 499 patients with mild-to-moderate CKD.
  • Measured multivariate association between baseline free p-cresol and cardiovascular events.
  • Follow-up averaged 33 months.

Main Results:

  • Higher free p-cresol concentrations were directly associated with cardiovascular events (univariate HR 1.79, P<0.0001).
  • P-cresol remained an independent predictor of cardiovascular events in multivariate analysis (HR 1.39, P=0.04), even after adjusting for GFR and Framingham risk factors.

Conclusions:

  • Free p-cresol may help predict CVD risk in renal patients across a spectrum of kidney function.
  • P-cresol offers predictive value beyond traditional markers like glomerular filtration rate.
  • Further research is needed to determine if p-cresol is a modifiable risk factor in CKD.
Abstract

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