新陈代谢,蛋白质绑定,肾清除率Microbiota-Derived p-Cresol CKD患者。

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de Loor Poesen R, Evenepoel P, H, kuyper D,内尔森Augustijns P, B

新陈代谢,蛋白质绑定,肾清除率Microbiota-Derived p-Cresol CKD患者。

中国J Soc Nephrol。2016年7月7日,11 (7):1136 - 44。doi: 10.2215 / CJN.00160116。Epub 2016年4月15日。

PubMed ID

27084876 (在PubMed

]

文摘

背景和目的:结肠微生物代谢大大有助于尿毒症保留CKD的溶质。p-Cresyl硫酸是这群溶质的主要代表,有关不良结果。除了硫酸接合,p-cresol受到内生葡糖苷酸接合。硫酸和葡糖苷酸之间的平衡接合是否相关在CKD是未知的。设计、设置、参与者,和测量:我们CKD患者前瞻性跟踪调查了488个阶段1 - 5(招生2005年11月和2006年9月之间;随访直到2010年12月)。血清和尿液p-cresyl硫酸盐和p-cresyl葡糖苷酸使用液相色谱-光谱法测定。的微生物总量p-cresol被血清硫酸p-cresyl之和计算,p-cresyl葡糖苷酸。结果分析了死亡率和心血管疾病。结果:血清硫酸p-cresyl是193.0倍的中位数(四分位范围,121.1 - -296.6)高于血清p-cresyl葡糖苷酸,与表皮生长因子受体之间的显著相关性和比例的血清硫酸p-cresyl葡糖苷酸(ρ= 0.23; P=0.001). There was also a significant correlation between eGFR and proportion of 24-hour urinary excretion of p-cresyl sulfate to glucuronide (rho=0.32; P<0.001). Higher serum p-cresol and lower proportion of serum p-cresyl sulfate to glucuronide were jointly and significantly associated with mortality (hazard ratio per SD higher, 1.58; 95% confidence interval, 1.10 to 2.29; P=0.01 and hazard ratio, 0.65; 95% confidence interval, 0.47 to 0.89; P<0.01, respectively) and cardiovascular disease (hazard ratio, 1.68; 95% confidence interval, 1.27 to 2.22; P<0.001 and hazard ratio, 0.55; 95% confidence interval, 0.42 to 0.72; P<0.001, respectively) after adjustment for eGFR, Framingham risk factors, mineral bone metabolism markers, C-reactive protein, and albumin. CONCLUSIONS: p-Cresol shows a preponderance of sulfate conjugation, although a relatively diminished sulfotransferase activity can be suggested in patients with advanced CKD. Along with total p-cresol burden, a relative shift from sulfate to glucuronide conjugation is independently associated with mortality and cardiovascular disease, warranting increased focus to the dynamic interplay between microbial and endogenous metabolism.

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