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2015 ; 10
(7
): e0132589
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Meta-Analysis of the Associations of p-Cresyl Sulfate (PCS) and Indoxyl Sulfate
(IS) with Cardiovascular Events and All-Cause Mortality in Patients with Chronic
Renal Failure
#MMPMID26173073
Lin CJ
; Wu V
; Wu PC
; Wu CJ
PLoS One
2015[]; 10
(7
): e0132589
PMID26173073
show ga
BACKGROUND: Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are protein-bound
uremic toxins that increase in the sera of patients with chronic kidney disease
(CKD), and are not effectively removed by dialysis. The purpose of this
meta-analysis was to investigate the relationships of PCS and IS with
cardiovascular events and all-cause mortality in patients with CKD stage 3 and
above. METHODOLOGY/PRINCIPLE FINDINGS: Medline, Cochrane, and EMBASE databases
were searched until January 1, 2014 with combinations of the following keywords:
chronic renal failure, end-stage kidney disease, uremic toxin, uremic retention,
indoxyl sulfate, p-cresyl sulfate. Inclusion criteria were: 1) Patients with
stage 1 to 5 CKD; 2) Prospective study; 3) Randomized controlled trial; 4)
English language publication. The associations between serum levels of PCS and IS
and the risks of all-cause mortality and cardiovascular events were the primary
outcome measures. Of 155 articles initially identified, 10 prospective and one
cross-sectional study with a total 1,572 patients were included. Free PCS was
significantly associated with all-cause mortality among patients with chronic
renal failure (pooled OR = 1.16, 95% CI = 1.03 to 1.30, P = 0.013). An elevated
free IS level was also significantly associated with increased risk of all-cause
mortality (pooled OR = 1.10, 95% CI = 1.03 to 1.17, P = 0.003). An elevated free
PCS level was significantly associated with an increased risk of cardiovascular
events among patients with chronic renal failure (pooled OR = 1.28, 95% CI = 1.10
to 1.50, P = 0.002), while free IS was not significantly associated with risk of
cardiovascular events (pooled OR = 1.05, 95% CI = 0.98 to 1.13, P = 0.196).
CONCLUSIONS/SIGNIFICANCE: Elevated levels of PCS and IS are associated with
increased mortality in patients with CKD, while PCS, but not IS, is associated
with an increased risk of cardiovascular events.