Open AccessThe Association of Uremic Toxins and Inflammation in Hemodialysis Patients
Author(s) -
Heng-Jung Hsu,
Chiung-Hui Yen,
IWen Wu,
Kuang-Hung Hsu,
ChihKen Chen,
ChiaoYin Sun,
Chia-Chi Chou,
Chun-Yu Chen,
Chi-Jen Tsai,
MaiSzu Wu,
ChinChan Lee
Publication year - 2014
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0102691
Subject(s) - hemodialysis , medicine , dialysis , creatinine , diabetes mellitus , inflammation , coronary artery disease , gastroenterology , uremia , interleukin 6 , serum amyloid a , kidney disease , endocrinology
Background Cardiovascular disease is the leading cause of mortality in hemodialysis patients and is associated with chronic inflammation. Elevation of uremic toxins, particular protein-bound uremic toxins, is a possible cause of hyper-inflammation in hemodialysis patients. But the association between uremic toxins and inflammatory markers in hemodialysis is still unclear. Methods We conducted a cross-sectional study to evaluate the association of the serum uremic toxins and inflammatory markers in hemodialysis patients. Results The uremic toxins were not associated with inflammatory markers- including high sensitivity C-reactive protein, IL(Interleukin) -1β, IL-6, tumor necrosis factor-α. In multiple linear regression, serum levels of total p -cresol sulfate ( P CS) were independently significantly associated with serum total indoxyl sulfate (IS) (standardized coefficient: 0.274, p <0.001), and co-morbidity of diabetes mellitus (DM) (standardized coefficient: 0.342, p <0.001) and coronary artery disease (CAD) (standardized coefficient: 0.128, p = 0.043). The serum total P CS levels in hemodialysis with co-morbidity of DM and CAD were significantly higher than those without co-morbidity of DM and CAD (34.10±23.44 vs. 16.36±13.06 mg/L, p <0.001). Serum levels of total IS was independently significantly associated with serum creatinine (standardized coefficient: 0.285, p <0.001), total P CS (standardized coefficient: 0.239, p = 0.001), and synthetic membrane dialysis (standardized coefficient: 0.139, p = 0.046). Conclusion The study showed that serum levels of total PCS and IS were not associated with pro-inflammatory markers in hemodialysis patients. Besides, serum levels of total P CS were independently positively significantly associated with co-morbidity of CAD and DM.