Abstract: SA-PO0412
Elevated p-Cresyl Sulfate Levels Predict Impaired Endothelial Function in Patients on Long-Term Peritoneal Dialysis
Session Information
- Home Dialysis: Science and Cases, from Lab to Living Room
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Chang, Ho-Hsiang, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Hsu, Bang-Gee, Division of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
Background
p-Cresyl sulfate (PCS), a protein-bound uremic toxin, contributes to inflammation, oxidative stress, and vascular dysfunction. Elevated PCS levels have been implicated in the development of cardiovascular diseases. This study aimed to investigate the relationship between serum PCS levels and endothelial function, assessed via vascular reactivity index (VRI), in patients undergoing long-term PD.
Methods
In this cross-sectional, single-center study, 82 patients with end-stage kidney disease receiving maintenance PD were enrolled. Endothelial function was evaluated using a digital thermal monitoring device that measured the VRI. VRI values were classified as follows: <1.0 (poor), 1.0–1.99 (intermediate), and ≥2.0 (good) vascular reactivity. Serum PCS concentrations were quantified using high-performance liquid chromatography-mass spectrometry. Clinical and biochemical parameters were recorded, and statistical analyses included correlation and multivariable linear regression models.
Results
Among the 82 patients, 38 (46.3%), 36 (43.9%), and 8 (9.8%) patients had poor, intermediate, and good vascular reactivity, respectively. Poor vascular reactivity was significantly associated with older age (P < 0.001), presence of diabetes mellitus (P = 0.018), higher waist circumference (P = 0.013), elevated serum C-reactive protein (CRP, P = 0.010), and increased PCS levels (P < 0.001), as well as lower diastolic blood pressure (DBP, P = 0.032) and serum creatinine (P = 0.005). VRI was negatively correlated with age (r = −0.442, P < 0.001), waist circumference (r = −0.355, P = 0.001), log-transformed CRP (log-CRP, r = −0.351, P < 0.001), and serum log-PCS (r = −0.578, P < 0.001), and positively correlated with DBP, total cholesterol, and creatinine. Multivariable regression revealed that age (β = −0.234, P = 0.008), waist circumference (β = −0.233, P = 0.008), and PCS levels (β = −0.452, P < 0.001) were independently associated with VRI. Spearman correlation analysis showed that age (r = 0.346, P = 0.001), and log-CRP (r = 0.262, P = 0.017) were positively correlated, while serum albumin (r = −0.256, P = 0.020), and creatinine (r = −0.335, P = 0.002) were negatively correlated with serum PCS levels.
Conclusion
Serum PCS levels were independently associated with endothelial dysfunction, as reflected by reduced VRI, in patients undergoing long-term PD.