ArticlePloS one2015
Free Levels of Selected Organic Solutes and Cardiovascular Morbidity and Mortality in Hemodialysis Patients: Results from the Retained Organic Solutes and Clinical Outcomes (ROSCO) Investigators.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers.
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Who cites it
61 citing papers in PubMed, 92 citations in OpenAlex.
- Gut Microbiome-Dependent Metabolic Pathways and Risk of Lethal Prostate Cancer: Prospective Analysis of a PLCO Cancer Screening Trial Cohort.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Trial
- Trial
- Results of the HEMO Study suggest that p-cresol sulfate and indoxyl sulfate are not associated with cardiovascular outcomes.Kidney international · 2017Trial
- Trial
- Cardiovascular-kidney-metabolic syndrome through the lens of gut‑derived uremic toxins.Gut microbes · 2026Review
- Targeting Protein-Bound Uremic Toxins: A Dual Approach with Medium Cut-Off Membrane Dialysis and a Dietary Intervention-A Randomized Controlled Study.Journal of clinical medicine · 2026Article
- Emerging Cardiovascular Risk Factors in Chronic Kidney Disease in the "Omics" Era: Gut and Beyond.Mayo Clinic proceedings · 2026Review
- Serum Phenylacetylglutamine Is a Potential Risk Factor for Aortic Stiffness in Patients with Chronic Hemodialysis.Diagnostics (Basel, Switzerland) · 2025Article
- Distinct Gut Microbiome Signatures in Hemodialysis and Kidney Transplant Populations.Journal of clinical medicine · 2025Article
- Effect of Kidney Transplant Type on Coronary Endothelial Function in Individuals with Chronic Kidney Disease.Annals of transplantation · 2025Observational
- Nonatherosclerotic Cardiovascular Disease in Chronic Kidney Disease.Cardiology clinics · 2025Review
- Gut-derived metabolites as treatment targets in chronic kidney disease-an avenue toward personalized medicine.Pediatric nephrology (Berlin, Germany) · 2025Article
- SerumDiagnostics (Basel, Switzerland) · 2025Article
- Gene Expression Profile of Cultured Human Coronary Arterial Endothelial Cells Exposed to Serum from Chronic Kidney Disease Patients: Role ofInternational journal of molecular sciences · 2025Article
- Orthopaedic fracture site and wound healing risk among end-stage renal disease patients undergoing open reduction internal fixation: A database analysis.Journal of clinical orthopaedics and trauma · 2025Article
- Review
- Liuwei Dihuang pills ameliorate renal injury in experimental type 2 diabetes mellitus rat by regulating host-gut microbiota interaction.Frontiers in pharmacology · 2025Article
- Does the Composition of Gut Microbiota Affect Chronic Kidney Disease? Molecular Mechanisms Contributed to Decreasing Glomerular Filtration Rate.International journal of molecular sciences · 2024Review
- Prognostic value of gut microbe-generated metabolite phenylacetylglutamine in patients with heart failure.European journal of heart failure · 2024Article
- Effects of AST-120 on mortality in patients with chronic kidney disease modeled by artificial intelligence or traditional statistical analysis.Scientific reports · 2024Article
1 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
objectivesNumerous substances accumulate in the body in uremia but those contributing to cardiovascular morbidity and mortality in dialysis patients are still undefined. We examined the association of baseline free levels of four organic solutes that are secreted in the native kidney - p-cresol sulfate, indoxyl sulfate, hippurate and phenylacetylglutamine - with outcomes in hemodialysis patients. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: We measured these solutes in stored specimens from 394 participants of a US national prospective cohort study of incident dialysis patients. We examined the relation of each solute and a combined solute index to cardiovascular mortality and morbidity (first cardiovascular event) using Cox proportional hazards regression adjusted for demographics, comorbidities, clinical factors and laboratory tests including Kt/VUREA.
resultsMean age of the patients was 57 years, 65% were white and 55% were male. In fully adjusted models, a higher p-cresol sulfate level was associated with a greater risk (HR per SD increase; 95% CI) of cardiovascular mortality (1.62; 1.17-2.25; p=0.004) and first cardiovascular event (1.60; 1.23-2.08; p<0.001). A higher phenylacetylglutamine level was associated with a greater risk of first cardiovascular event (1.37; 1.18-1.58; p<0.001). Patients in the highest quintile of the combined solute index had a 96% greater risk of cardiovascular mortality (1.96; 1.05-3.68; p=0.04) and 62% greater risk of first cardiovascular event (1.62; 1.12-2.35; p=0.01) compared with patients in the lowest quintile. Results were robust in sensitivity analyses.
conclusionsFree levels of uremic solutes that are secreted by the native kidney are associated with a higher risk of cardiovascular morbidity and mortality in incident hemodialysis patients.
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