Indoxyl sulfate associates with cardiovascular phenotype in children with chronic kidney disease

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dc.contributor.authorHolle J.
dc.contributor.authorQuerfeld U.
dc.contributor.authorKirchner M.
dc.contributor.authorAnninos A.
dc.contributor.authorOkun J.
dc.contributor.authorThurn-Valsassina D.
dc.contributor.authorBayazit A.
dc.contributor.authorNiemirska A.
dc.contributor.authorCanpolat N.
dc.contributor.authorBulut I.K.
dc.contributor.authorDuzova A.
dc.contributor.authorAnarat A.
dc.contributor.authorShroff R.
dc.contributor.authorBilginer Y.
dc.contributor.authorCaliskan S.
dc.contributor.authorCandan C.
dc.contributor.authorHarambat J.
dc.contributor.authorÖzcakar Z.B.
dc.contributor.authorSoylemezoglu O.
dc.contributor.authorTschumi S.
dc.contributor.authorHabbig S.
dc.contributor.authorYilmaz E.
dc.contributor.authorBalat A.
dc.contributor.authorZurowska A.
dc.contributor.authorCakar N.
dc.contributor.authorKranz B.
dc.contributor.authorErtan P.
dc.contributor.authorMelk A.
dc.contributor.authorAzukaitis K.
dc.contributor.authorSchaefer F.
dc.date.accessioned2019-10-26T21:14:08Z
dc.date.available2019-10-26T21:14:08Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground: Cardiovascular disease is the leading cause of death in children with chronic kidney disease (CKD). Serum levels of gut-derived uremic toxins increase with deterioration of kidney function and are associated with cardiac comorbidities in adult CKD patients. Methods: Indoxyl sulfate (IS) and p-cresyl sulfate (pCS) were measured by high-performance liquid chromatography in serum of children participating in the Cardiovascular Comorbidity in Children with CKD (4C) Study. Results were correlated with measurements of the carotid intima-media thickness (cIMT), central pulse wave velocity (PWV), and left ventricular mass index (LVMI) in children aged 6–17 years with initial eGFR of 10–60 ml/min per 1.73 m2. Results: The median serum levels of total IS and of pCS, measured in 609 patients, were 5.3 µmol/l (8.7) and 17.0 µmol/l (21.6), respectively. In a multivariable regression model, IS and pCS showed significant positive associations with urea and negative associations with eGFR and uric acid. Furthermore, positive associations of pCS with age, serum albumin, and non-Mediterranean residency and a negative association with glomerular disease were observed. By multivariable regression analysis, only IS was significantly associated with a higher cIMT SDS at baseline and progression of PWV SDS within 12 months, independent of other risk factors. Conclusions: Serum levels of gut-derived uremic toxins IS and pCS correlated inversely with eGFR in children. Only IS was significantly associated with surrogate markers of cardiovascular disease in this large pediatric CKD cohort. © 2019, IPNA.en_US
dc.description.sponsorship01EO0802en_US
dc.description.sponsorshipThis study was made possible by grants from the European Renal Association-European Dialysis and Transplant Association ( www.era-edta.org ), the Kuratorium für Dialyse und Nierentransplantation (KfH) Foundation for Preventive Medicine, the German Federal Ministry of Education and Research (reference no. 01EO0802), and Pfizer Deutschland GmbH. The entire study was solely initiated and performed by the investigators of the 4C study group. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. --en_US
dc.identifier.doi10.1007/s00467-019-04331-6
dc.identifier.issn0931041X
dc.identifier.issn0931-041Xen_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1007/s00467-019-04331-6
dc.identifier.urihttps://hdl.handle.net/11454/15840
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherSpringer Verlagen_US
dc.relation.ispartofPediatric Nephrologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectCardiovascular diseaseen_US
dc.subjectChronic kidney diseaseen_US
dc.subjectUremiaen_US
dc.subjectUremic toxinsen_US
dc.titleIndoxyl sulfate associates with cardiovascular phenotype in children with chronic kidney diseaseen_US
dc.typeArticleen_US

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