Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population

[en] 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. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Disciplines :

Urology & nephrology
Pediatrics

Author, co-author :

Snauwaert, Evelien; Ghent University Hospital, Ghent, 9000, Belgium

Holvoet, Els; Ghent University Hospital, Ghent, 9000, Belgium

Van Biesen, Wim; Ghent University Hospital, Ghent, 9000, Belgium

Raes, Ann; Ghent University Hospital, Ghent, 9000, Belgium

Glorieux, Griet; Ghent University Hospital, Ghent, 9000, Belgium

Vande Walle, Johan; Ghent University Hospital, Ghent, 9000, Belgium

Roels, Sanne; Department of Data Analysis, Faculty of Psychology and Pedagogy, Ghent University, Ghent, 9000, Belgium

Vanholder, Raymond; Ghent University Hospital, Ghent, 9000, Belgium

Askiti, Varvara; A&PKyriakouChildren’sHospital, Athens, 11527, Greece

Azukaitis, Karolis; Clinic of Pediatrics, Faculty of Medicine, Vilnius University, Vilnius, 08406, Lithuania

More authors (19 more)

Language :

English

Title :

Uremic toxin concentrations are related to residual kidney function in the pediatric hemodialysis population

Publication date :

24 April 2019

Journal title :

Toxins

eISSN :

2072-6651

Publisher :

MDPI AG

Volume :

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

Federal Agency for Science and Innovation: IWT, IWT-TBM 150195National Institute for Health ResearchBaxter InternationalAmgen

Available on ORBi :

since 28 January 2020

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