scholarly journals The Roles of Indoxyl Sulphate and p-Cresyl Sulphate in Patients with Chronic Kidney Disease: A Review of Therapeutic Options

2018 ◽  
Author(s):  
Melissa Nataatmadja ◽  
Yeoungjee Cho ◽  
Katrina Campbell ◽  
David W. Johnson
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Therapeutic Options ◽  
Indoxyl Sulphate

scholarly journals P0744CLINICAL IMPACT OF SERUM INDOXYL SULPHATE MEASURED BY NEW ENZYMATIC METHOD IN PATIENTS WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Yoshinari Yasuda ◽  
Ryosuke Kikuchi ◽  
Kazunori Goto ◽  
Ahmad Baseer Kaihan ◽  
Sawako Kato ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Measurement Method ◽  
Multiple Logistic Regression Analysis ◽  
Rank Test ◽  
Uremic Toxin ◽  
Enzymatic Method ◽  
Renal Outcomes ◽  
Indoxyl Sulphate

Abstract Background and Aims Uremic toxins have been highlighted as serious risk factors for deterioration of renal function and onset/progression of cardiovascular diseases (CVD). Serum level of indoxyl sulphate (IS), a major uremic toxin, was demonstrated its significant association with vascular disease and mortality in a cohort of chronic kidney disease (CKD) patients, however, IS has not been available in clinical setting due to time consuming and expensive measurement cost. Recently epoch-making IS measurement method applicable for general auto analyzer has been developed, which could explore new therapeutic avenue in CKD from the view point of uremic toxin management. In this study, clinical utility of new enzymatic IS measurement method was analyzed in association with renal function and CVD among CKD patients. Method Subjects were consecutive 150 CKD patients in Nagoya University Hospital whose serum samples were collected between 2009 and 2014. Serum IS levels were measured by “NIPRO” reagent and analyzed with eGFR, CVD events and renal outcomes defined by 30% decrease in eGFR. Results Characteristics of patients were 69 ± 10 years old, 29% female, eGFR: 44 ± 20 mL/min/1.73m2 (∼G3a: 43％, G3b: 29％, G4: 24％, Ｇ5: 4％), proteinuria 2.8 ± 3. 5ｇ/ｇCr (A1: 29％, A2: 29％, A3: 42％), HTN: 83％, and DM: 39％. Serum IS levels (μmol/L) were 10.5 ± 7.5 (∼G3a: 1.8 ± 0.6, G3b: 2.1 ± 0.6, G4: 15.8 ± 8.1, Ｇ5: 22.9 ± 13.5), and strongly correlated with eGFR (r =0.518, P<0.001). Among IS low (<6), middle and high (≥12) tertiles, significantly different factors were age, eGFR, Hb, iPTH and LDL-C. In multiple logistic regression analysis, only eGFR was significant associating factor with IS tertiles. IS levels in 2 patients prescribed AST-120 (Kremezin) were 8.1 and 10.3, which seems to be very low in comparison to their eGFR of 13.8 and 13.7. During observation period of 5.1 ± 1.0 years, 59 renal outcomes and 9 CVD events were observed. Kaplan-Meier survival curve analysis free from renal outcomes revealed better tendency in IS low group (p= 0.0617 in log-rank test). According to IS levels adjusted by eGFR, only 1 out of 9 CVD events occurred in low IS/eGFR tertile group. Conclusion Serum IS levels could be measured in new enzymatic method. Strong correlation between IS and eGFR was demonstrated, and AST-120 might be effective to improve IS. In renal and CVD outcome analysis, more sample size is needed for further study.

The Co-Existence of NASH and Chronic Kidney Disease Boosts Cardiovascular Risk: Are there any Common Therapeutic Options?

2018 ◽  
Vol 16 (3) ◽  
pp. 254-268 ◽  
Author(s):  
Marianna Papademetriou ◽  
Vasilios G. Athyros ◽  
Eleni Geladari ◽  
Michael Doumas ◽  
Costas Tsioufis ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Therapeutic Options

Abstract 264: Oral Activated Charcoal Adsorbent (AST-120) Inhibition of Chronic Kidney Disease-induced Atherosclerosis Involves Modulation of Intestinal Immunity

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Yohei Tsuchida ◽  
Ashley Wilheln ◽  
Amy Major ◽  
Sean Davies ◽  
Macrae Linton ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
T Cells ◽  
Kidney Disease ◽  
Lymph Nodes ◽  
Immune Cells ◽  
Activated Charcoal ◽  
Serum Levels ◽  
Mesenteric Lymph Nodes ◽  
Mesenteric Lymph ◽  
Indoxyl Sulphate

Introduction and Aims: Although patients with chronic kidney disease (CKD) are at the highest risk for atherosclerotic cardiovascular disease (CVD), current interventions (e.g. statins) that are consistently effective in other high-risk groups have been found to be insufficiently effective in CKD. Serum levels of uremic toxins including indoxyl sulphate have been implicated in cardiovascular mortality. The oral charcoal absorbent AST-120 reduces serum levels of indoxyl sulphate through adsorption of indole converted from dietary tryptophan in the gastrointestinal tract. Previously, we reported the inhibitory effects of AST-120 on progression of atherosclerosis in apoE-deficient hyperlipidemic mice. Because gut immunity can affect systemic inflammatory responses and atherogenesis, we hypothesized that the AST-120-mediated benefits in CKD-acceleration of atherosclerosis involve modulation of intestinal immune cells. Methods: Eleven week old apoE-deficient mice underwent a reduction in renal mass through subtotal nephrectomy (sNx, n=34) or sham-operation (S, n=14). Two weeks later, each of the 2 groups was further divided into AST-120-treated or untreated mice. Six weeks later, we used flow cytometry and real time PCR to examine the population of immune cells in intestinal Peyer’s patches and mesenteric lymph nodes. Results: AST-120 had no significant effect on cellular populations of Peyer’s patch or mesenteric lymph nodes in mice with intact kidneys. Interestingly, however, in sNX mice treatment with AST-120 significantly decreased numbers of Peyer’s patch cytotoxic T cells (-19.6%; P=0.008), CD8 + central memory T cells (-33.9%; P=0.014), and CD8 + naïve T cells (-42.6%; P=0.004) compared to controls. In mesenteric lymph nodes of sNX animals, AST-120 did not affect CD4 + T helper cell number, but reduced early activated CD4 + T cells (-13.1%; P=0.04). Cytokine expression in mesenteric lymph nodes of AST-treated sNX mice showed increases in TGF-β (+47.2%; P=0.022) and IL-10 (+36.5%). Conclusions: The mechanism underlying the ability of oral activated charcoal adsorbent AST-120 to inhibit the acceleration of atherosclerosis in the setting of CKD may involve modulation of immune cells in the gut mucosa.

scholarly journals p-Cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease

2010 ◽  
Vol 26 (3) ◽  
pp. 938-947 ◽  
Author(s):  
I.-W. Wu ◽  
K.-H. Hsu ◽  
C.-C. Lee ◽  
C.-Y. Sun ◽  
H.-J. Hsu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Indoxyl Sulphate
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