Dataset Information

P-Cresol and cardiovascular risk in mild-to-moderate kidney disease.

ABSTRACT:

Background and objectives

Cardiovascular disease is highly prevalent in chronic kidney disease. Traditional risk factors are insufficient to explain the high cardiovascular disease prevalence. Free p-cresol serum concentrations, mainly circulating as its derivative p-cresyl sulfate, are associated with cardiovascular disease in hemodialysis patients. It is not known if p-cresol is associated with cardiovascular disease in patients with chronic kidney disease not yet on dialysis.

Design, setting, participants, & measurements

In a prospective observational study in 499 patients with mild-to-moderate kidney disease, we examined the multivariate association between p-cresol free serum concentrations and cardiovascular events.

Results

After a mean follow-up of 33 mo, 62 patients reached the primary end point of fatal or nonfatal cardiovascular events. Higher baseline concentrations of free p-cresol were directly associated with cardiovascular events (univariate hazard ratio [HR] 1.79, P<0.0001). In multivariate analysis, p-cresol remained a predictor of cardiovascular events, independent of GFR and independent of Framingham risk factors (full model, HR 1.39, P=0.04).

Conclusions

These findings suggest that p-cresol measurements may help to predict cardiovascular disease risk in renal patients over a wide range of residual renal function, beyond traditional markers of glomerular filtration. Whether p-cresol is a modifiable cardiovascular risk factor in CKD patients remains to be proven.

SUBMITTER: Meijers BK

PROVIDER: S-EPMC2893077 | biostudies-literature | 2010 Jul

REPOSITORIES: biostudies-literature

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p-Cresol and cardiovascular risk in mild-to-moderate kidney disease.

Meijers Björn K I BK Claes Kathleen K Bammens Bert B de Loor Henriette H Viaene Liesbeth L Verbeke Kristin K Kuypers Dirk D Vanrenterghem Yves Y Evenepoel Pieter P

Clinical journal of the American Society of Nephrology : CJASN 20100429 7

<h4>Background and objectives</h4>Cardiovascular disease is highly prevalent in chronic kidney disease. Traditional risk factors are insufficient to explain the high cardiovascular disease prevalence. Free p-cresol serum concentrations, mainly circulating as its derivative p-cresyl sulfate, are associated with cardiovascular disease in hemodialysis patients. It is not known if p-cresol is associated with cardiovascular disease in patients with chronic kidney disease not yet on dialysis.<h4>Desig ...[more]

PMID: 20430946

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