PT  - JOURNAL ARTICLE
AU  - Barreto, Fellype C.
AU  - Barreto, Daniela V.
AU  - Liabeuf, Sophie
AU  - Meert, Natalie
AU  - Glorieux, Griet
AU  - Temmar, Mohammed
AU  - Choukroun, Gabriel
AU  - Vanholder, Raymond
AU  - Massy, Ziad A.
AU  - , 
TI  - Serum Indoxyl Sulfate Is Associated with Vascular Disease and Mortality in Chronic Kidney Disease Patients
AID  - 10.2215/CJN.03980609
DP  - 2009 Oct 01
TA  - Clinical Journal of the American Society of Nephrology
PG  - 1551--1558
VI  - 4
IP  - 10
4099  - http://cjasn.asnjournals.org/content/4/10/1551.short
4100  - http://cjasn.asnjournals.org/content/4/10/1551.full
SO  - CLIN J AM SOC NEPHROL2009 Oct 01; 4
AB  - Background and objectives: As a major component of uremic syndrome, cardiovascular disease is largely responsible for the high mortality observed in chronic kidney disease (CKD). Preclinical studies have evidenced an association between serum levels of indoxyl sulfate (IS, a protein-bound uremic toxin) and vascular alterations. The aim of this study is to investigate the association between serum IS, vascular calcification, vascular stiffness, and mortality in a cohort of CKD patients. Design, setting, participants, & measurements: One-hundred and thirty-nine patients (mean ± SD age: 67 ± 12; 60% male) at different stages of CKD (8% at stage 2, 26.5% at stage 3, 26.5% at stage 4, 7% at stage 5, and 32% at stage 5D) were enrolled. Results: Baseline IS levels presented an inverse relationship with renal function and a direct relationship with aortic calcification and pulse wave velocity. During the follow-up period (605 ± 217 d), 25 patients died, mostly because of cardiovascular events (n = 18). In crude survival analyses, the highest IS tertile was a powerful predictor of overall and cardiovascular mortality (P = 0.001 and 0.012, respectively). The predictive power of IS for death was maintained after adjustment for age, gender, diabetes, albumin, hemoglobin, phosphate, and aortic calcification. Conclusions: The study presented here indicates that IS may have a significant role in the vascular disease and higher mortality observed in CKD patients.