Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Kidney Blood Press Res. 2012;35(6):583-8. doi: 10.1159/000339709. Epub 2012 Aug 21.
Protein-bound uremic toxins indoxyl sulfate (IS) and p-cresol sulfate (p-CS) have been implicated as an important factor in uremic syndrome. Recent evidence indicates that both IS and p-CS are predictors of cardiovascular as well as all-cause mortality among chronic dialysis patients. We conducted a study to analyze the relationship between IS and p-CS and vascular access (VA) outcome in chronic hemodialysis (HD) patients.
A total of 91 chronic stable HD patients were divided into groups according to survival of VA and frequency of VA dysfunction. Demographic and biochemical data were reviewed and recorded. Serum levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1, and the total and free forms of IS and p-CS were determined.
Patients with a history of frequent VA failure and dysfunction had lower albumin and higher levels of ICAM-1, free IS, free and total p-CS. Diabetes was associated with higher IS and p-CS. Logistic regression revealed that diabetes and free p-CS were independent factors associated with poor outcome of VA.
Endothelial dysfunction and uremic toxins were associated with survival and function of VA. Diabetes and free p-CS were significantly related to the outcome of VA among chronic HD patients.
蛋白结合性尿毒症毒素吲哚硫酸酯（IS）和对甲酚硫酸盐（p-CS）被认为是尿毒症综合征的一个重要因素。最近的证据表明，IS 和 p-CS 都是慢性透析患者心血管和全因死亡率的预测因素。我们进行了一项研究，以分析 IS 和 p-CS 与慢性血液透析（HD）患者血管通路（VA）结局之间的关系。
将 91 例慢性稳定 HD 患者根据 VA 存活和 VA 功能障碍的频率分为两组。回顾和记录人口统计学和生化数据。测定细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1 以及 IS 和 p-CS 的总形式和游离形式的血清水平。
VA 频繁失败和功能障碍病史的患者白蛋白水平较低，ICAM-1、游离 IS、游离和总 p-CS 水平较高。糖尿病与较高的 IS 和 p-CS 有关。Logistic 回归显示，糖尿病和游离 p-CS 是与 VA 不良结局相关的独立因素。
内皮功能障碍和尿毒症毒素与 VA 的存活和功能有关。糖尿病和游离 p-CS 与慢性 HD 患者 VA 的结局显著相关。
