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Kidney Week

Abstract: PO0607

Indoxyl and Cresyl Sulfate Are Respectively Linked to Phosphocalcic Metabolism Abnormalities and to Cardiovascular Morbidity in Hemodialysed Patients

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Bologna, Arianna, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Vezzoli, Giuseppe, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Foligno, Nadia Edvige, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Avino, Monica, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Del Mastro, Teresa, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
  • Arcidiacono, Teresa, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
Background

Indoxyl sulfate (IS) and Cresyl sulfate (CS) are uremic toxins generated by the intestinal amino acid catabolism. Blood levels of these toxins increase in patients with CKD and are linked to cardiovascular events.

Methods

Therefore, we studied the relationship between serum levels of free IS and CS and divalent ion metabolism variables and cardiovascular morbidity (stroke, heart failure, angor and myocardial infarction) in 139 hemodialysis patients (age 68+13 yrs, weight 65+13 kg, dialysis vintage 69+71 months).
We divided patients according to tertiles of free serum IS and CS.

Results

Patients in the highest tertile of serum free IS showed shorter dialysis vintage and higher body weight gain between dialysis sessions than patients in the other two tertiles. Patients in the highest tertile of IS showed lower body weight and serum concentrations of alkaline phosphatase, 1, 25(OH)2D and PTH compared to the lowest tertile.
No relationships of serum free CS concentrations with phosphate and calcium metabolism variables were observed.
Kaplan-Meier survival analysis shows an increased cardiovascular morbidity in patients in the CS highest tertile (blue line in the figure) compared to those in the lowest and middle tertiles taken together (red line; p=0.01). This association was not found considering IS tertiles.

Conclusion

Our findings suggest that serum IS could predispose to adynamic bone disease, while CS may have higher cardiovascular toxicity.