Association between indoxyl sulfate and bone histomorphometry in pre-dialysis chronic kidney disease patients

Jornal Brasileiro de Nefrologia

Fellype Carvalho Barreto¹  Daniela Veit Barreto¹  Maria Eugênia Fernandes Canziani¹  Cristianne Tomiyama¹  Andrea Higa¹  Anaïs Mozar¹  Griet Glorieux¹  Raymond Vanholder¹  Ziad Massy¹  Aluizio Barbosa De Carvalho¹ 

关键词: renal insufficiency;    chronic;    indoxyl sulfate;    renal osteodystrophy;    uremia;    indoxil sulfato;    insuficiência renal crônica;    osteodistrofia renal;    uremia;   

DOI  :  10.5935/0101-2800.20140042

来源: SciELO

【 摘 要 】

Introduction: Experimental studies have suggested that indoxyl sulfate (IS), a protein-bound uremic toxin, may be involved in the development of renal osteodystrophy. Objective: evaluate the association between IS levels and biochemical parameters related to mineral metabolism and bone histomorphometry in a cohort of pre-dialysis chronic kidney disease (CKD) patients. Methods: This is a post-hoc analysis of an observational study evaluating the association between coronary calcification and bone biopsy findings in 49 patients (age: 52 ± 10 years; 67% male; estimated glomerular filtration rate: 36 ± 17 ml/min). Serum levels of IS were measured. Results:Patients at CKD stages 2 and 3 presented remarkably low bone formation rate. Patients at CKD stages 4 and 5 presented significantly higher osteoid volume, osteoblast and osteoclast surface, bone fibrosis volume and bone formation rate and a lower mineralization lag time than CKD stage 2 and 3 patients. We observed a positive association between IS levels on one hand and the bone formation rate, osteoid volume, osteoblast surface and bone fibrosis volume on the other. Multivariate regression models confirmed that the associations between IS levels and osteoblast surface and bone fibrosis volume were both independent of demographic and biochemical characteristics of the study population. A similar trend was observed for the bone formation rate. Conclusion: Our findings demonstrated that IS is positively associated with bone formation rate in pre-dialysis CKD patients.

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