Trial reportKidney international2017
Results of the HEMO Study suggest that p-cresol sulfate and indoxyl sulfate are not associated with cardiovascular outcomes.
Trial report in Kidney international, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 79 citations in OpenAlex.
- Metabolomic Profiling Delineates Stage-Associated Metabolic Remodelling in Cardiovascular-Kidney-Metabolic Syndrome.Diabetes/metabolism research and reviews · 2026Article
- Lymphocyte Phenotypes and Protein-Bound Uremic Toxins as Determinants of Clinical Outcomes in Hemodialysis Patients.International journal of molecular sciences · 2025Observational
- Microbial Metabolites and Cardiovascular Dysfunction: A New Era of Diagnostics and Therapy.Cells · 2025Review
- Gut-Heart Axis: The Role of Gut Microbiota and Metabolites in Heart Failure.Circulation research · 2025Review
- Gut-derived metabolites as treatment targets in chronic kidney disease-an avenue toward personalized medicine.Pediatric nephrology (Berlin, Germany) · 2025Article
- The Role of the Gut Microbiota in Complications among Hemodialysis Patients.Microorganisms · 2024Review
- Residual Kidney Function in Hemodialysis: Its Importance and Contribution to Improved Patient Outcomes.Toxins · 2024Review
- Predictive value of protein-bound uremic toxins for heart failure in patients with chronic kidney disease.ESC heart failure · 2024Article
- Causal association between 1400 metabolites and dilated cardiomyopathy: a bidirectional two-sample Mendelian randomization analysis.Frontiers in endocrinology · 2024Article
- Phenylacetylglutamine and trimethylamine N-oxide: Two uremic players, different actions.European journal of clinical investigation · 2023Observational
- Article
- Assessment of uremic toxins in advanced chronic kidney disease patients on maintenance hemodialysis by LC-ESI-MS/MS.Metabolomics : Official journal of the Metabolomic Society · 2023Article
- Physiological Mechanisms of Hypertension and Cardiovascular Disease in End-Stage Kidney Disease.Current hypertension reports · 2022Review
- Kynurenine pathway metabolites predict subclinical atherosclerotic disease and new cardiovascular events in chronic kidney disease.Clinical kidney journal · 2022Article
- Contribution of Hypoalbuminemia and Anemia to the Prognostic Value of Plasma p-Cresyl Sulfate and p-Cresyl Glucuronide for Cardiovascular Outcome in Chronic Kidney Disease.Journal of personalized medicine · 2022Article
- Serum total indoxyl sulfate levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study.BMC nephrology · 2022Article
- Review
- Effects of the L-tyrosine-derived bacterial metabolite p-cresol on colonic and peripheral cells.Amino acids · 2022Review
- A metabolomics approach identified toxins associated with uremic symptoms in advanced chronic kidney disease.Kidney international · 2022Article
- Indoxyl sulfate in uremia: an old idea with updated concepts.The Journal of clinical investigation · 2022Article
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
Cardiovascular disease, the leading cause of mortality in hemodialysis patients, is not fully explained by traditional risk factors. To help define non-traditional risk factors, we determined the association of predialysis total p-cresol sulfate, indoxyl sulfate, phenylacetylglutamine, and hippurate with cardiac death, sudden cardiac death, and first cardiovascular event in the 1,273 participants of the HEMO Study. The results were adjusted for potential demographic, clinical, and laboratory confounders. The mean age of the patients was 58 years, 63% were Black and 42% were male. Overall, there was no association between the solutes and outcomes. However, in sub-group analyses, among patients with lower serum albumin (under 3.6 g/dl), a twofold higher p-cresol sulfate was significantly associated with a 12% higher risk of cardiac death (hazard ratio 1.12; 95% confidence interval, 0.98-1.27) and 22% higher risk of sudden cardiac death (1.22, 1.06-1.41). Similar trends were also noted with indoxyl sulfate. Trial interventions did not modify the association between these solutes and outcomes. Routine clinical and lab data explained less than 22% of the variability in solute levels. Thus, in prevalent hemodialysis patients participating in a large U.S. hemodialysis trial, uremic solutes p-cresol sulfate, indoxyl sulfate, hippurate, and phenylacetylglutamine were not associated with cardiovascular outcomes. However, there were trends of toxicity among patients with lower serum albumin.
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