Abstract
Method Patients on hemodialysis over 6 months were enrolled in this prospective cohort study and were divided into 2 groups based on plasma p-cresyl sulfate level. The primary end point was the first episode of ischemic stroke during follow-up. The association between p-cresyl sulfate and ischemic stroke incidence was analyzed by Kaplan-Meier method and Cox proportional hazard model. Results 220 patients were enrolled in this study. 44 patients experienced episodes of first ischemic stroke during follow-up for 87.8 (47.6-119.5) months. Kaplan-Meier analysis demonstrated that the incidence of ischemic stroke in the high p-cresyl sulfate group was significantly higher than that in the low p-cresyl sulfate group (Log-Rank P = 0.007). Cox regression analysis as well proved that p-cresyl sulfate level was significantly associated with the first incidence of ischemic stroke (HR (hazard ratio) 2.332, 95% CI (95% confidence interval) 1.236-4.399, P = 0.009). After being adjusted for other confounding risk factors, the results persisted significant (model 11: HR 2.061, 95% CI 1.030-4.125, P = 0.041). Conclusion Plasma p-cresyl sulfate predicts the first incidence of ischemic stroke in hemodialysis patients.
Highlights
The relationship between kidney diseases and cerebrovascular diseases has become increasingly recognized in recent years
The incidence of cerebrovascular disease is higher among chronic kidney disease (CKD) patients compared to that in the healthy population, and the prevalence of cerebrovascular disease is higher in more advanced stages of CKD [1]
It is critical to identify particular risk factors for stroke in end-stage renal disease (ESRD), to develop novel prevention measures and treatment strategies. In this prospective cohort study, we found that a protein-bound uremic toxin, p-cresyl sulfate, predicts the incidence of newly developed ischemic stroke in hemodialysis patients
Summary
The relationship between kidney diseases and cerebrovascular diseases has become increasingly recognized in recent years. Protein-bound uremic toxins have recently been noted as a potential link in cardiorenal syndrome [5], and removal of protein-bound uremic toxins by dialysis is extremely difficult due to their high protein-binding affinity [6] This has been well demonstrated with two of the most typical protein-bound uremic toxins: p-cresyl sulfate (PCS) [7–10] and indoxyl sulfate (IS) [11–13]. P-Cresyl sulfate is a typical protein-bound uremic toxin that contributes to chronic kidney disease and cardiovascular disease progression, as well as mortality in hemodialysis patients. The present study was aimed at elucidating the association between p-cresyl sulfate and the risk of ischemic stroke in hemodialysis patients. The association between p-cresyl sulfate and ischemic stroke incidence was analyzed by Kaplan-Meier method and Cox proportional hazard model. Plasma p-cresyl sulfate predicts the first incidence of ischemic stroke in hemodialysis patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
