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Iwasaki, Keiichiro Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences
Miyoshi, Toru Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Urabe, Chikara Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences
Sakuragi, Satoru Department of Cardiovascular Medicine, Iwakuni Clinical Center
Kawai, Yusuke Department of Cardiovascular Medicine, Okayama City Hospital
Fuke, Soichiro Department of Cardiovascular Medicine, Japanese Red Cross Okayama Hospital
Doi, Masayuki Department of Cardiology, Kagawa Prefectural Central Hospital
Takaishi, Atsushi Department of Cardiology, Mitoyo General Hospital
Oka, Takefumi Department of Cardiology, Tsuyama Chuo Hospital
Tokunaga, Naoto Department of Cardiology, Ibara City Hospital
Ito, Hiroshi Department of General Internal Medicine 3, Kawasaki Medical School Kaken ID
Abstract
Background/Objectives: Indoxyl sulfate, a uremic toxin, is associated with mortality and cardiovascular events in patients with chronic kidney disease (CKD). This study aimed to evaluate the prognostic implications of serum indoxyl sulfate levels in patients with heart failure and CKD. Methods and Results: This was a prospective multicenter observational study. Overall, 300 patients with chronic heart failure with a previous history of hospitalization and an estimated glomerular filtration rate (eGFR) of 45 mL/min/1.73 m2 or less (CKD stage G3b to G5) without dialysis were analyzed. The primary outcome assessed in a time-to-event analysis from the measurement of indoxyl sulfate was a composite of all-cause death, hospitalization for heart failure, nonfatal myocardial infarction, and nonfatal stroke. Clinical events were followed-up to one year after indoxyl sulfate measurement. The median patient age was 75 years, and 57% of the patients were men. We divided the cohort into low and high indoxyl sulfate categories according to a median value of 9.63 mg/mL. The primary outcome occurred in 27 of 150 patients (18.0%) in the low indoxyl sulfate group and 27 of 150 patients (18.0%) in the high indoxyl sulfate group (hazard ratio, 1.00; 95% confidence interval, 0.58 to 1.70, p = 0.99). In the post hoc exploratory analyses, the results were consistent across age, sex, body mass index, left ventricular ejection fraction, eGFR, and N-terminal pro b-type natriuretic peptide. Conclusions: Among heart failure patients with CKD stages G3b to 5G, serum indoxyl sulfate concentrations were not significantly associated with the subsequent occurrence of cardiovascular events.
Keywords
heart failure
chronic kidney disease
indoxyl sulfate
Published Date
2024-07-26
Publication Title
Journal of Clinical Medicine
Volume
volume13
Issue
issue15
Publisher
MDPI
Start Page
4384
ISSN
2077-0383
Content Type
Journal Article
language
English
OAI-PMH Set
岡山大学
Copyright Holders
© 2024 by the authors.
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isVersionOf https://doi.org/10.3390/jcm13154384
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https://creativecommons.org/licenses/by/4.0/
Citation
Iwasaki, K.; Miyoshi, T.; Urabe, C.; Sakuragi, S.; Kawai, Y.; Fuke, S.; Doi, M.; Takaishi, A.; Oka, T.; Tokunaga, N.; et al. Impact of Serum Indoxyl Sulfate on One-Year Adverse Events in Chronic Kidney Disease Patients with Heart Failure. J. Clin. Med. 2024, 13, 4384. https://doi.org/10.3390/jcm13154384
Funder Name
KUREHA Corporation