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No. 11 (PC 11)
Indoxyl Sulfate is an Independent Risk Factor for Coronary Heart Disease in
Patients with Chronic Kidney Disease
Ippei Watanabe 1 , Shunji Namba 2 , Yuko Okuda 2 , Akiko Morimoto 2 , Tetsumi Kojima 2 ,
Masanari Sano 2 , Toshisuke Morita 1
1. Deartment of Laboratory Medicine Graduate School of Medicine Toho University, Japan
2. Clinical Laboratory Toho University Omori Medical Center, Japan
Background: Chronic kidney disease (CKD) has been recognized as an independent risk factor for
coronary heart disease (CHD). Indoxyl sulfate (IS), one of uremic toxins, may play an important role
in cardio-renal syndrome and our previous in vitro study showed that IS mediates vascular toxicity
through enhanced oxidative stress in human endothelial cells. However, it is still unclear how
accumulated IS in patients with renal dysfunction affects clinical outcome in those patients. In the
present study, we examined the relation between CHD and serum IS levels in patients with CKD.
Methods: In November 2010, patients in different CKD stages were divided into two groups (CHD
group n=50 and non-CHD group n=62). CHD was diagnosed by coronary angiography, nuclear
cardiac scintigraphy or multi-slice CT. The background and clinical characteristics of two groups were
compared using receiver-operating characteristic analysis and multivariate analysis. The cut-off value of
serum IS level was calculated to achieve its risk index on CHD.
Results: Serum IS levels were significantly higher in the CHD group than in the non-CHD group
(P