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ID 67534
フルテキストURL
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著者
Iwasaki, Keiichiro Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences
Miyoshi, Toru Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Urabe, Chikara Department of Cardiovascular Medicine, Okayama University Institute of Academic and Research, Medicine, Dentistry and Pharmaceutical Sciences
Sakuragi, Satoru Department of Cardiovascular Medicine, Iwakuni Clinical Center
Kawai, Yusuke Department of Cardiovascular Medicine, Okayama City Hospital
Fuke, Soichiro Department of Cardiovascular Medicine, Japanese Red Cross Okayama Hospital
Doi, Masayuki Department of Cardiology, Kagawa Prefectural Central Hospital
Takaishi, Atsushi Department of Cardiology, Mitoyo General Hospital
Oka, Takefumi Department of Cardiology, Tsuyama Chuo Hospital
Tokunaga, Naoto Department of Cardiology, Ibara City Hospital
Ito, Hiroshi Department of General Internal Medicine 3, Kawasaki Medical School Kaken ID
抄録
Background/Objectives: Indoxyl sulfate, a uremic toxin, is associated with mortality and cardiovascular events in patients with chronic kidney disease (CKD). This study aimed to evaluate the prognostic implications of serum indoxyl sulfate levels in patients with heart failure and CKD. Methods and Results: This was a prospective multicenter observational study. Overall, 300 patients with chronic heart failure with a previous history of hospitalization and an estimated glomerular filtration rate (eGFR) of 45 mL/min/1.73 m2 or less (CKD stage G3b to G5) without dialysis were analyzed. The primary outcome assessed in a time-to-event analysis from the measurement of indoxyl sulfate was a composite of all-cause death, hospitalization for heart failure, nonfatal myocardial infarction, and nonfatal stroke. Clinical events were followed-up to one year after indoxyl sulfate measurement. The median patient age was 75 years, and 57% of the patients were men. We divided the cohort into low and high indoxyl sulfate categories according to a median value of 9.63 mg/mL. The primary outcome occurred in 27 of 150 patients (18.0%) in the low indoxyl sulfate group and 27 of 150 patients (18.0%) in the high indoxyl sulfate group (hazard ratio, 1.00; 95% confidence interval, 0.58 to 1.70, p = 0.99). In the post hoc exploratory analyses, the results were consistent across age, sex, body mass index, left ventricular ejection fraction, eGFR, and N-terminal pro b-type natriuretic peptide. Conclusions: Among heart failure patients with CKD stages G3b to 5G, serum indoxyl sulfate concentrations were not significantly associated with the subsequent occurrence of cardiovascular events.
キーワード
heart failure
chronic kidney disease
indoxyl sulfate
発行日
2024-07-26
出版物タイトル
Journal of Clinical Medicine
13巻
15号
出版者
MDPI
開始ページ
4384
ISSN
2077-0383
資料タイプ
学術雑誌論文
言語
英語
OAI-PMH Set
岡山大学
著作権者
© 2024 by the authors.
論文のバージョン
publisher
PubMed ID
DOI
Web of Science KeyUT
関連URL
isVersionOf https://doi.org/10.3390/jcm13154384
ライセンス
https://creativecommons.org/licenses/by/4.0/
Citation
Iwasaki, K.; Miyoshi, T.; Urabe, C.; Sakuragi, S.; Kawai, Y.; Fuke, S.; Doi, M.; Takaishi, A.; Oka, T.; Tokunaga, N.; et al. Impact of Serum Indoxyl Sulfate on One-Year Adverse Events in Chronic Kidney Disease Patients with Heart Failure. J. Clin. Med. 2024, 13, 4384. https://doi.org/10.3390/jcm13154384
助成機関名
KUREHA Corporation