Serum indoxyl sulfate predicts adverse cardiovascular events in patients with chronic kidney disease

Abstract

Background/purpose: Indoxyl sulfate (IS) is a protein-binding molecule that exhibits cardiovascular (CV) toxicity. This study determined whether the serum IS level can be used to predict the risk of major adverse CV events (MACEs) in patients with chronic kidney disease (CKD). Methods: We studied 147 patients with CKD stage 1–5 over a 3-year follow-up period. IS was measured through mass spectrometry. Patients’ demographics were collected and analyzed to predict outcomes by using multivariable Cox regression. Results: Forty-seven (32.0%) patients had MACEs. IS remained significantly associated with MACEs after multivariable regression analysis. The area under the receiver operating characteristic curve for IS levels was 0.708 (95% confidence interval: 0.618–0.798). Conclusion: IS may have a critical role in the prediction of CV disease in patients with CKD. Further large-scale investigations are warranted and suggested. Keywords: Chronic kidney disease (CKD), Indoxyl sulfate (IS), Protein-bound uremic toxins, Major adverse cardiovascular events (MACEs), Prognosis