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Association between Protein-Bound Uremic Toxins and Asymptomatic Cardiac Dysfunction in Patients with Chronic Kidney Disease.
- Source :
-
Toxins [Toxins (Basel)] 2018 Dec 05; Vol. 10 (12). Date of Electronic Publication: 2018 Dec 05. - Publication Year :
- 2018
-
Abstract
- Although the relationship between protein-bound uremic toxins (PBUTs) and cardiac structure and cardiac mortality in chronic kidney disease (CKD) has been studied in the past, the association between cardiac dysfunction and PBUTs has not yet been studied. We therefore evaluated the association between impaired peak cardiac performance and the serum free and total concentrations of potentially cardiotoxic PBUTs. In a cross-sectional study of 56 male CKD patients (stages 2⁻5 (pre-dialysis)) who were asymptomatic with no known cardiac diseases or diabetes we measured peak cardiac power (CPO <subscript>max</subscript> ), aerobic exercise capacity (VO <subscript>2max</subscript> ), and echocardiographic parameters of cardiac morphology and evaluated their association with PBUTs. The serum total and free concentrations of indoxyl sulfate (IXS), p-cresyl sulfate (PCS), p-cresyl glucuronide, indole acetic acid, and hippuric acid showed significant negative correlation with CPO <subscript>max</subscript> and VO <subscript>2max</subscript> . IXS and PCS were independently associated with CPO <subscript>max</subscript> and VO <subscript>2max</subscript> even after controlling for eGFR. No correlation between left ventricular mass index (LVMI) and PBUTs was seen. The present study for the first time has demonstrated the association between subclinical cardiac dysfunction in CKD and serum levels of a panel of PBUTs. Further studies are required to evaluate the mechanism of cardiotoxicity of the individual uremic toxins.
- Subjects :
- Adult
Arterial Pressure
Cardiac Output
Cresols blood
Exercise
Glucuronides blood
Heart Rate
Hippurates blood
Humans
Indican blood
Indoleacetic Acids blood
Male
Middle Aged
Sulfuric Acid Esters blood
Heart Diseases blood
Heart Diseases physiopathology
Renal Insufficiency, Chronic blood
Renal Insufficiency, Chronic physiopathology
Toxins, Biological blood
Uremia blood
Uremia physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 2072-6651
- Volume :
- 10
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Toxins
- Publication Type :
- Academic Journal
- Accession number :
- 30563136
- Full Text :
- https://doi.org/10.3390/toxins10120520