P-cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease

I. Wen Wu, Kuang Hung Hsu, Chin Chan Lee, Chiao Yin Sun, Heng Jung Hsu, Chi Jen Tsai, Chin Yuan Tzen, Yen Chih Wang, Ching Yuang Lin, Mai Szu Wu

Research output: Contribution to journalArticlepeer-review

387 Citations (Scopus)


Background: Indoxyl sulphate (IS) and p-cresyl sulphate (PCS) are uraemic toxins that have similar protein binding, dialytic clearance and proinflammatory features. However, only a few prospective studies have evaluated possible associations between these two retained solutes and renal disease progression in chronic kidney disease (CKD) patients.Methods. This prospective observational study evaluated independent associations between serum total IS and PCS with renal progression in a selected cohort of patients having different stages of CKD. Baseline PCS and IS were correlated with renal progression [defined as decrements in estimated glomerular filtration rate (eGFR) > 50% from baseline or progression to end-stage renal disease (ESRD)] and death during a follow-up period of 24 months.Results. Of 268 patients, 35 (13.1%) had renal progression and 14 (5.2%) died after a mean follow-up of 21 ± 3 months. Univariate Cox regression analysis followed by multivariate analysis showed that high-serum PCS levels were associated with renal progression and all-cause mortality independent of age, gender, diabetes status, albumin levels, serum IS, serum creatinine, Ca × P product, intact parathyroid hormone, haemoglobin or high-sensitivity C-reactive protein level. Serum IS was only associated with renal progression; however, the predictive power of serum IS was weakened when serum PCS was also present in the analytical model.Conclusions. In addition to traditional and uraemia-related risk factors such as renal function, serum IS and PCS levels may help in predicting the risk of renal progression in patients having different stages of CKD.

Original languageEnglish
Pages (from-to)938-947
Number of pages10
JournalNephrology Dialysis Transplantation
Issue number3
Publication statusPublished - Mar 2011
Externally publishedYes


  • chronic kidney disease
  • indoxyl sulphate
  • p-cresyl sulphate
  • protein-bound toxins
  • proximal tubule

ASJC Scopus subject areas

  • Nephrology
  • Transplantation


Dive into the research topics of 'P-cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease'. Together they form a unique fingerprint.

Cite this