P-cresyl sulfate is a valuable predictor of clinical outcomes in pre-ESRD patients
Cheng-Jui Lin1, Chi-Feng Pan2, Chih-Kuang Chuang3
1Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, 92 Chung San North Road, 10449 Taipei, Taiwan ; Department of Medical Research, Mackay Memorial Hospital, 10449 Taipei, Taiwan ; Department of Laboratory Medicine, Mackay Memorial Hospital, 10449 Taipei, Taiwan.
Background/Aims:
Previous studies have reported p-cresyl sulfate (PCS) was related to endothelial dysfunction and adverse clinical effect. We investigate the adverse effects of PCS on clinical outcomes in a chronic kidney disease (CKD) cohort study.
Methods:
72 predialysis patients were enrolled from a single medical center. Serum biochemistry data and PCS were measured. The clinical outcomes including cardiovascular event, all-cause mortality, and dialysis event were recorded during a 3-year follow-up.
Results:
After adjusting other independent variables, multivariate Cox regression analysis showed age (HR: 1.12, P = 0.01), cardiovascular disease history (HR: 6.28, P = 0.02), and PCS (HR: 1.12, P = 0.02) were independently associated with cardiovascular event; age (HR: 0.91, P < 0.01), serum albumin (HR: 0.03, P < 0.01), and PCS level (HR: 1.17, P < 0.01) reached significant correlation with dialysis event. Kaplan-Meier analysis revealed that patients with higher serum p-cresyl sulfate (>6 mg/L) were significantly associated with cardiovascular and dialysis event (log rank P = 0.03, log rank P < 0.01, resp.).
Conclusion:
Our study shows serum PCS could be a valuable marker in predicting cardiovascular event and renal function progression in CKD patients without dialysis.
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