TY - JOUR
T1 - Role of anuria in the relationship between indoxyl sulfate and anemia in peritoneal dialysis patients
AU - Huang, Jeng Yi
AU - Hsu, Ching Wei
AU - Yang, Chih Wei
AU - Hung, Cheng Chieh
AU - Huang, Wen Hung
N1 - Publisher Copyright:
© 2016 Huang et al.
PY - 2016/11/28
Y1 - 2016/11/28
N2 - Background: Experimental evidence suggests that indoxyl sulfate (IS) is associated with chronic kidney disease-related anemia. However, clinical studies are limited, and few have explored the potential confounding effect of anuria. This study, thus, evaluated the association between IS and anemia in both non-anuric and anuric peritoneal dialysis (PD) patients. Methods: This cross-sectional and observational study included 165 chronic PD patients aged 19-84 years. Their serum IS levels in total and free forms were measured by ultra performance liquid chromatography. Correlations between serum IS and hemoglobin (Hb) were performed in both non-anuric and anuric groups. Results: Among the study subjects, 90 were non-anuric and 75 were anuric. As a whole, there was no correlation between IS and Hb. Nonetheless, subsequent analysis of the non-anuric patients showed that Hb is negatively correlated with IS levels (rs=−0.405, P<0.001 for total form and rs=−0.296, P=0.005 for free form). Factors that significantly affected Hb levels in the stepwise multiple regression analysis include total IS and iron saturation. In contrast for anuric patients, serum ferritin, albumin, iron saturation, use of angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker, but not serum IS, were predictors for anemia in the multiple regression model. Conclusions: Serum IS is associated with an increased severity of anemia in non-anuric PD patients and not in anuric ones, indicating anuria could be a confounding factor in such association.
AB - Background: Experimental evidence suggests that indoxyl sulfate (IS) is associated with chronic kidney disease-related anemia. However, clinical studies are limited, and few have explored the potential confounding effect of anuria. This study, thus, evaluated the association between IS and anemia in both non-anuric and anuric peritoneal dialysis (PD) patients. Methods: This cross-sectional and observational study included 165 chronic PD patients aged 19-84 years. Their serum IS levels in total and free forms were measured by ultra performance liquid chromatography. Correlations between serum IS and hemoglobin (Hb) were performed in both non-anuric and anuric groups. Results: Among the study subjects, 90 were non-anuric and 75 were anuric. As a whole, there was no correlation between IS and Hb. Nonetheless, subsequent analysis of the non-anuric patients showed that Hb is negatively correlated with IS levels (rs=−0.405, P<0.001 for total form and rs=−0.296, P=0.005 for free form). Factors that significantly affected Hb levels in the stepwise multiple regression analysis include total IS and iron saturation. In contrast for anuric patients, serum ferritin, albumin, iron saturation, use of angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker, but not serum IS, were predictors for anemia in the multiple regression model. Conclusions: Serum IS is associated with an increased severity of anemia in non-anuric PD patients and not in anuric ones, indicating anuria could be a confounding factor in such association.
KW - Anemia
KW - Anuria
KW - Indoxyl sulfate
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=85000363028&partnerID=8YFLogxK
U2 - 10.2147/TCRM.S120012
DO - 10.2147/TCRM.S120012
M3 - 文章
AN - SCOPUS:85000363028
SN - 1176-6336
VL - 12
SP - 1797
EP - 1803
JO - Therapeutics and Clinical Risk Management
JF - Therapeutics and Clinical Risk Management
ER -