p-Cresol and Cardiovascular Risk in Kidney Transplant Recipients

Area of Science:

• Nephrology
• Cardiology
• Biochemistry

Background:

• p-Cresol Sulphate (pCS) is a uremic toxin linked to chronic kidney disease (CKD) and cardiovascular disease (CVD).
• Elevated pCS is associated with poor outcomes in CKD patients.
• The role of pCS in kidney transplant recipients (KTRs) requires further investigation.

Purpose of the Study:

• To evaluate plasma pCS levels in KTRs.
• To assess the relationship between pCS, estimated glomerular filtration rate (eGFR), cardiovascular risk factors, and endothelial progenitor cells (EPCs) in KTRs.

Main Methods:

• Analyzed plasma pCS levels using LC/ESI-MS/MS in 51 KTRs and 25 healthy blood donors (HBDs).
• Assessed EPCs via flow cytometry.
• Calculated eGFR and collected data on traditional risk factors and cardiovascular events.

Main Results:

• No significant difference in pCS levels between KTRs and HBDs overall.
• pCS levels were inversely related to eGFR in KTRs.
• KTRs with eGFR < 30 mL/min/1.73 m² had lower pCS than HBDs, but higher than KTRs with eGFR > 30 mL/min/1.73 m².
• pCS levels showed a trend towards association with previous vascular events and were inversely related to mature EPCs.

Conclusions:

• pCS may not be an independent CVD risk marker in KTRs compared to HBDs.
• Reduced eGFR in KTRs is associated with increased pCS and impaired vascular repair capacity (reduced EPCs).
• pCS serves as a marker of the uremic state and global vascular competence in KTRs.