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Serum total indoxyl sulfate levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study.
Li, Qian; Zhang, Shuang; Wu, Qi-Jun; Xiao, Jia; Wang, Zhi-Hong; Mu, Xiang-Wei; Zhang, Yu; Wang, Xue-Na; You, Lian-Lian; Wang, Sheng-Nan; Song, Jia-Ni; Zhao, Xiu-Nan; Wang, Zhen-Zhen; Yan, Xin-Yi; Jin, Yu-Xin; Jiang, Bo-Wen; Liu, Shu-Xin.
Affiliation
  • Li Q; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • Zhang S; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Wu QJ; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • Xiao J; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Wang ZH; Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
  • Mu XW; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • Zhang Y; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Wang XN; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • You LL; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Wang SN; School of Maritime Economics and Management, Dalian Maritime University, Dalian, China.
  • Song JN; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • Zhao XN; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Wang ZZ; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • Yan XY; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Jin YX; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
  • Jiang BW; Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, Dalian, China.
  • Liu SX; Department of Nephrology, Dalian Municipal Central Hospital, No.826, Xinan Road, Dalian, Liaoning, 116033, P. R. China.
BMC Nephrol ; 23(1): 231, 2022 06 28.
Article in En | MEDLINE | ID: mdl-35764943
BACKGROUND: The association between serum total indoxyl sulfate (tIS), and cardiovascular disease (CVD) and all-cause mortality is a matter of debate. In the current study we sought to determine the association, if any, between serum tIS, and all-cause and CVD-associated mortality in patients on maintenance hemodialysis (MHD). METHODS: A prospective cohort study was conducted involving 500 MHD patients at Dalian Municipal Central Hospital from 31 December 2014 to 31 December 2020. Serum tIS levels were measured at baseline and classified as high (≥44.16 ng/ml) or low (< 44.16 ng/ml) according to the "X-tile" program. Besides, the associations between continuous serum tIS and outcomes were also explored. Predictors were tested for colinearity using variance inflation factor analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression models. Restricted cubic spline model was performed to assess dose-response relationships between tIS concentration and all-cause and CVD mortality. RESULTS: During a 58-month median follow-up period, 224 deaths (132 CVD deaths) were documented. After adjustment for potential confounders, the serum tIS level was positively associated with all-cause mortality (HR = 1.02, 95% = 1.01-1.03); however, we did not detect a significant association when tIS was a dichotomous variable. Compared with the MHD population with a serum tIS level < 44.16 ng/ml, the adjusted HR for CVD mortality among those with a serum tIS level ≥ 44.16 ng/ml was 1.76 (95% = 1.10-2.82). Furthermore, we also noted the same association when the serum tIS level was a continuous variable. CONCLUSION: The serum tIS level was associated with higher risk of all-cause and CVD mortality among MHD patients. Further prospective large-scale studies are required to confirm this finding.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiovascular Diseases / Indican Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: BMC Nephrol Journal subject: NEFROLOGIA Year: 2022 Document type: Article Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiovascular Diseases / Indican Type of study: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: BMC Nephrol Journal subject: NEFROLOGIA Year: 2022 Document type: Article Country of publication: United kingdom