Uremic Solutes in Chronic Kidney Disease and Their Role in Progression.

Autor: van den Brand JA; Department of Nephrology, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands., Mutsaers HA; Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands., van Zuilen AD; Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands., Blankestijn PJ; Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands., van den Broek PH; Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands., Russel FG; Department of Pharmacology and Toxicology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands., Masereeuw R; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands., Wetzels JF; Department of Nephrology, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2016 Dec 29; Vol. 11 (12), pp. e0168117. Date of Electronic Publication: 2016 Dec 29 (Print Publication: 2016).
DOI: 10.1371/journal.pone.0168117
Abstrakt: Background: To date, over 150 possible uremic solutes have been listed, but their role in the progression of CKD is largely unknown. Here, the association between a selected panel of uremic solutes and progression in CKD patients was investigated.
Methods: Patients from the MASTERPLAN study, a randomized controlled trial in CKD patients with a creatinine clearance between 20 and 70 ml/min per 1.73m2, were selected based on their rate of eGFR decline during the first five years of follow-up. They were categorized as rapid (decline >5 ml/min per year) or slow progressors. Concentrations of eleven uremic solutes were obtained at baseline and after one year of follow-up. Logistic regression was used to compare the odds for rapid to slow progression by uremic solute concentrations at baseline. Variability in uremic solute levels was assessed using scatter plots, and limits of variability were calculated.
Results: In total, 40 rapidly and 40 slowly progressing patients were included. Uremic solutes were elevated in all patients compared to reference values for healthy persons. The serum levels of uremic solutes were not associated with rapid progression. Moreover, we observed substantial variability in solute levels over time.
Conclusions: Elevated concentrations of uremic solutes measured in this study did not explain differences in rate of eGFR decline in CKD patients, possibly due to lack of power as a result of the small sample size, substantial between patient variability, and variability in solute concentrations over time. The etiology of intra-individual variation in uremic solute levels remains to be elucidated.
Competing Interests: The MASTERPLAN study was supported by grants from the Dutch Kidney foundation (www.nierstichting.nl, NSN PV01) and the Netherlands Heart Foundation (www.hartstichting.nl, Hartstischting, 2003B261). H. A. M. Mutsaers was supported by the Dutch Kidney Foundation (grant number IK08.03; www.nierstichting.nl). Unrestricted grants were provided by Amgen Netherlands (www.amgen.nl), Genzyme Netherlands (www.genzyme.nl), Pfizer Netherlands (www.pfizer.nl) and Sanofi-Aventis Netherlands (www.sanofi.nl). There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.
Databáze: MEDLINE
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