Serum indoxyl sulfate predicts adverse cardiovascular events in patients with chronic kidney disease

Area of Science:

• Nephrology
• Cardiology
• Biomarker Discovery

Background:

• Indoxyl sulfate (IS) is a protein-bound uremic toxin known to cause cardiovascular (CV) toxicity.
• Chronic kidney disease (CKD) patients exhibit elevated IS levels.
• The predictive value of IS for CV events in CKD is not fully established.

Purpose of the Study:

• To investigate the association between serum IS levels and the risk of major adverse cardiovascular events (MACEs) in patients with CKD.
• To determine if IS can serve as a predictive biomarker for CV outcomes in this population.

Main Methods:

• A cohort of 147 patients with CKD stages 1-5 was followed for 3 years.
• Serum IS levels were quantified using mass spectrometry.
• Multivariable Cox regression analysis was employed to assess the predictive value of IS for MACEs, controlling for demographics.

Main Results:

• A significant proportion of patients (32.0%) experienced MACEs during the follow-up period.
• Elevated serum IS levels were independently associated with an increased risk of MACEs.
• The area under the receiver operating characteristic curve (AUC) for IS was 0.708, indicating moderate predictive accuracy.

Conclusions:

• Serum IS levels demonstrate potential as a predictive biomarker for cardiovascular disease in patients with CKD.
• These findings suggest a critical role for IS in CV risk stratification for CKD patients.
• Larger-scale studies are recommended to further validate these results.