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Serum P-Cresyl Sulfate Is Associated with Peripheral Arterial Stiffness in Chronic Hemodialysis Patients

Yahn-Bor Chern1, Chih-Hsien Wang2,3, Chin-Hung Liu4,5

  • 1Division of Nephrology, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada.

Diagnostics (Basel, Switzerland)
|September 27, 2025
PubMed

Insights

Serum p-Cresyl sulfate (PCS) is linked to arterial stiffness in hemodialysis patients. Higher PCS levels may help diagnose peripheral arterial stiffness (PAS), a key cardiovascular risk factor.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biomarker Discovery

Background:

  • Arterial stiffness is a significant cardiovascular risk factor in patients undergoing hemodialysis (HD).
  • Peripheral arterial stiffness (PAS), measured by cardio-ankle vascular index (CAVI), is a key indicator.
  • Understanding factors contributing to PAS in HD patients is crucial for risk stratification.

Purpose of the Study:

  • To investigate the association between serum p-Cresyl sulfate (PCS) and peripheral arterial stiffness (PAS) in chronic HD patients.
  • To evaluate the diagnostic value of PCS for identifying arterial stiffness in this population.

Main Methods:

  • A cross-sectional study involving 110 chronic HD patients.
  • Patients were categorized into PAS (CAVI ≥ 9.0) and control (CAVI < 9.0) groups.
  • Serum PCS levels were quantified using high-performance liquid chromatography-mass spectrometry.

Main Results:

  • Peripheral arterial stiffness (PAS) was present in 33.6% of patients.
  • PAS patients were older, had higher systolic blood pressure, more diabetes, and elevated serum PCS and C-reactive protein (CRP).
  • Multivariate analysis confirmed a significant association between PAS and PCS (adjusted OR: 1.238 per 1 mg/L increase, p < 0.001).
  • PCS showed good diagnostic value for PAS (AUC: 0.872, p < 0.001) with an optimal cutoff of 24.29 mg/L.

Conclusions:

  • Serum p-Cresyl sulfate (PCS) is significantly associated with arterial stiffness in hemodialysis patients.
  • PCS demonstrates potential as a valuable biomarker for diagnosing arterial stiffness.
  • Further research may explore PCS as a therapeutic target to mitigate cardiovascular risk in HD patients.

Keywords:
C-reactive proteincardio-ankle vascular indexhemodialysisp-Cresyl sulfateperipheral arterial stiffness

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