Title Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population /
Authors Snauwaert, Evelien ; Holvoet, Els ; Van Biesen, Wim ; Raes, Ann ; Glorieux, Griet ; Walle, Johan Vande ; Roels, Sanne ; Vanholder, Raymond ; Askiti, Varvara ; Ažukaitis, Karolis ; Bayazit, Aysun ; Canpolat, Nur ; Fischbach, Michel ; Godefroid, Nathalie ; Krid, Saoussen ; Litwin, Mieczyslaw ; Obrycki, Lukasz ; Paglialonga, Fabio ; Ranchin, Bruno ; Samaille, Charlotte ; Schaefer, Franz ; Schmitt, Claus Peter ; Spasojevic, Brankica ; Stefanidis, Constantinos J ; Van Dyck, Maria ; Van Hoeck, Koen ; Collard, Laure ; Eloot, Sunny ; Shroff, Rukshana
DOI 10.3390/toxins11040235
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Is Part of Toxins.. Basel : MDPI AG. 2019, vol. 11, iss. 4, art. no. 235, p. [1-15].. eISSN 2072-6651
Keywords [eng] Child ; Chronic kidney disease ; End-stage kidney disease ; Hemodialysis ; Residual kidney function ; Uremic toxins
Abstract [eng] Protein-bound uremic toxins (PBUTs) play a role in the multisystem disease that children on hemodialysis (HD) are facing, but little is known about their levels and protein binding (%PB). In this study, we evaluated the levels and %PB of six PBUTs cross-sectionally in a large pediatric HD cohort (n = 170) by comparing these with healthy and non-dialysis chronic kidney disease (CKD) stage 4-5 (n = 24) children. In parallel β2-microglobulin (β2M) and uric acid (UA) were evaluated. We then explored the impact of age and residual kidney function on uremic toxin levels and %PB using analysis of covariance and Spearman correlation coefficients (rs). We found higher levels of β2M, p-cresyl glucuronide (pCG), hippuric acid (HA), indole acetic acid (IAA), and indoxyl sulfate (IxS) in the HD compared to the CKD4-5 group. In the HD group, a positive correlation between age and pCG, HA, IxS, and pCS levels was shown. Residual urine volume was negatively correlated with levels of β2M, pCG, HA, IAA, IxS, and CMPF (rs -0.2 to -0.5). In addition, we found overall lower %PB of PBUTs in HD versus the CKD4-5 group, and showed an age-dependent increase in %PB of IAA, IxS, and pCS. Furhtermore, residual kidney function was overall positively correlated with %PB of PBUTs. In conclusion, residual kidney function and age contribute to PBUT levels and %PB in the pediatric HD population.
Published Basel : MDPI AG
Type Journal article
Language English
Publication date 2019