Role of anuria in the relationship between indoxyl sulfate and anemia in peritoneal dialysis patients

Jeng Yi Huang, Ching Wei Hsu, Chih Wei Yang, Cheng Chieh Hung, Wen Hung Huang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

9 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1797-1803
Number of pages7
JournalTherapeutics and Clinical Risk Management
Volume12
DOIs
StatePublished - 28 11 2016

Bibliographical note

Publisher Copyright:
© 2016 Huang et al.

Keywords

  • Anemia
  • Anuria
  • Indoxyl sulfate
  • Peritoneal dialysis

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