Circulating p-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease
Autor: | Cai Mei Zheng, Chang Chin Wu, Kuo Cheng Lu, Mai Szu Wu, Ting Ming Wang, Jia-Feng Chang, Chih Yu Hsieh, Shu-Wei Chang, Jian Chiun Liou |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
medicine.medical_specialty p-cresyl sulfate Health Toxicology and Mutagenesis medicine.medical_treatment Population 030232 urology & nephrology Toxicology Gastroenterology 03 medical and health sciences 0302 clinical medicine Chronic kidney disease-mineral and bone disorder Internal medicine Bone cell medicine education Hyperparathyroidism education.field_of_study business.industry Hazard ratio Bone fracture medicine.disease 030104 developmental biology bone fracture chronic kidney disease–mineral and bone disorder Medicine Hemodialysis business alkaline phosphatase Kidney disease |
Zdroj: | Toxins Volume 13 Issue 7 Toxins, Vol 13, Iss 479, p 479 (2021) |
ISSN: | 2072-6651 |
DOI: | 10.3390/toxins13070479 |
Popis: | Patients with chronic kidney disease (CKD), especially those undergoing hemodialysis, are at a considerably high risk of bone fracture events. Experimental data indicate that uremic toxins intricately involved in bone-related proteins exert multi-faced toxicity on bone cells and tissues, leading to chronic kidney disease–mineral and bone disorder (CKD-MBD). Nonetheless, information regarding the association between p-cresyl sulfate (PCS), non-hepatic alkaline phosphatase (NHALP) and skeletal events remains elusive. We aim to explore the association between PCS, NHALP and risk of bone fracture (BF) in patients with hemodialysis. Plasma concentrations of PCS and NHALP were ascertained at study entry. Cox proportional hazard regression analyses were used to determine unadjusted and adjusted hazard ratios (aHRs) of PCS for BF risk. In multivariable analysis, NHALP was associated with incremental risks of BFs [aHR: 1.06 (95% CI: 1.01–1.11)]. The association between the highest PCS tertile and BF risk remained robust [aHR: 2.87 (95% CI: 1.02–8.09)]. With respect to BF events, the interaction between NHALP and PCS was statistically significant (p value for the interaction term < 0.05). In addition to mineral dysregulation and hyperparathyroidism in hemodialysis patients, higher circulating levels of PCS and NHALP are intricately associated with incremental risk of BF events, indicating that a joint evaluation is more comprehensive than single marker. In light of the extremely high prevalence of CKD-MBD in the hemodialysis population, PCS may act as a pro-osteoporotic toxin and serve as a potential surrogate marker for skeletal events. |
Databáze: | OpenAIRE |
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