Impact of Indoxyl Sulfate on Coronary Plaques in Patients on Hemodialysis
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- Asami Masahiko
- Division of Cardiology, Mitsui Memorial Hospital
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- Tanabe Kengo
- Division of Cardiology, Mitsui Memorial Hospital
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- Ito Shunsuke
- Adsorptive Medicine Technology Center, Kureha Corporation Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University
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- Yoshida Eri
- Division of Cardiology, Mitsui Memorial Hospital
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- Aoki Jiro
- Division of Cardiology, Mitsui Memorial Hospital
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- Tanimoto Shuzou
- Division of Cardiology, Mitsui Memorial Hospital
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- Horiuchi Yu
- Division of Cardiology, Mitsui Memorial Hospital
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- Yoshida Masayuki
- Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University
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説明
<p>Serum indoxyl sulfate (IS; a uremic toxin) levels, which are significantly higher in patients with chronic kidney disease, including those undergoing hemodialysis, than in the robust, are associated with both cardiovascular disease (CVD) and CVD-related mortality. Furthermore, coronary artery calcium (CAC) is an independent predictor of cardiovascular events in patients undergoing hemodialysis. This study aimed to interpret the association between serum IS levels and coronary plaque burden (CPB) or CAC.</p><p>A total of 30 consecutive patients on hemodialysis, who underwent 320-row coronary multidetector computed tomography (MDCT) angiography for suspected coronary artery disease, were enrolled in this prospective study. Coronary artery percent atheroma volume (a CPB marker) and percent calcium volume (a CAC marker) assessed using MDCT were evaluated. Furthermore, various oxidative and inflammatory markers typified by serum IS levels at a dialysis-free day were measured. Using these data, we investigated correlation between the inflammatory marker IS and CPB or CAC.</p><p>Multivariable analysis indicated that serum IS levels were positively correlated with CAC [partial regression coefficient, 2.89; 95% confidence interval (CI), 0.35-5.43; P = 0.03] but not with CPB, even after adjustment for cofounders. Composite cardiovascular events, namely, as all-cause death, non-fatal myocardial infarction, disabling stroke, and hospital admission for other cardiovascular events, were reported to be 50% in all patients (95% CI, 32.1-67.9).</p><p>In patients undergoing hemodialysis, serum IS levels were significantly associated with CAC but not with CPB.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 59 (3), 489-496, 2018-05-31
一般社団法人 インターナショナル・ハート・ジャーナル刊行会