Association between the uremic toxins indoxyl-sulfate and p-cresyl-sulfate with sarcopenia and malnutrition in elderly patients with advanced chronic kidney disease

L. Caldiroli, S. Armelloni, A. Eskander, P. Messa, V. Rizzo, E. Margiotta, M. Cesari, S. Vettoretti

Research output: Contribution to journalArticlepeer-review

Abstract

Background: in patients with chronic kidney disease (CKD) indoxyl sulfate (IS) and p-cresyl sulfate (PCs) may induce sarcopenia either directly or via systemic inflammation. We evaluated whether IS and PCs were associated with: sarcopenia, systemic inflammation and nutritional status. Methods: we examined cross sectionally 93 patients with advanced CKD. Sarcopenia was identified according to EWGSOP2 definition. Malnutrition was assessed by Malnutrition Inflammation Score (MIS) and Protein Energy Wasting syndrome (PEW). Inflammatory status was assessed by dosing: CRP, IL6, TNFα, MCP1, IL10, IL17, IL12p70. Results: we did not find any association of sarcopenia with IS and PCs. IS was associated with LogTNFα and LogMCP-1 in the overall cohort (r = 0.30, p = 0.0043; r = 0.22 p = 0.047) and in not sarcopenic patients (r = 0.32, p = 0.0077; r = 0.25, p = 0.041). PCs was associated with LogIL10 and LogIL12p70 in sarcopenic patients (r = 0.58, p = 0.0042; r = 0.52, p = 0.013). IS was higher in patients without PEW (p = 0.029), while PCs was higher in patients with PEW (p = 0.0040). IS and PCs were not different in patients with normal or increased MIS. Conclusions: IS and PCs were not associated with sarcopenia, although they were both associated with some inflammatory pathways. Notably, we found a positive association of PCs with PEW syndrome.

Original languageEnglish
Article number111266
JournalExperimental Gerontology
Volume147
DOIs
Publication statusPublished - 2021

Keywords

  • Chronic kidney disease
  • Indoxyl sulfate
  • Inflammation
  • Malnutrition
  • p-cresyl sulfate
  • Sarcopenia
  • 4 cresyl sulfate
  • C reactive protein
  • indican
  • interleukin 10
  • interleukin 12p70
  • interleukin 17
  • interleukin 6
  • monocyte chemotactic protein 1
  • tumor necrosis factor
  • unclassified drug
  • uremic toxin
  • aged
  • Article
  • body mass
  • chronic kidney failure
  • controlled study
  • cross-sectional study
  • female
  • human
  • major clinical study
  • male
  • malnutrition
  • malnutrition inflammation score
  • nutritional assessment
  • priority journal
  • protein calorie malnutrition
  • sarcopenia
  • uremia

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