Death Clinical Trial
End-stage renal disease is a global epidemia with an estimated incidence of 7% per year and
high morbidity-mortality rate. Early detection of chronic kidney disease (CKD) and
intervention for CKD complication is important to retard renal progression. However,
"traditional uremic toxin" or "small water-soluble molecules" are poorly correlated with the
renal function, uremic symptoms and outcomes of CKD patients.
Putative protein-bound solute, p-cresol, is accumulated in ESRD patients receiving dialysis
therapy. This uremic solute was associated with endothelial dysfunction, immune
dysregulation and can predict outcome in hemodialysis patient. P-cresol inhibits endothelial
cell proliferation and endothelial response to inflammatory cytokines. In vitro, p-cresol
decreases leukocyte transendotherliar migratory function and inhibit production of phagocyte
reactive species. Clinically, p-cresol plays a pathophysiological role in the uremic
toxicity. High free serum level of p-cresol is associated with mortality in hemodialysis
patients.
Information of p-cresol in CKD patients is not available. The investigators hypothesized
p-cresol can be accumulated in early CKD and have a positive correlation with the morbidity-
mortality of CKD patients.
Value of p-cresol in different stages of CRF is still unknown. Information of p-cresol in
CKD patients is not available. The investigators hypothesized p-cresol can be accumulated in
early CKD and have a positive correlation with the morbidity- mortality of CKD patients.
The principal aim of this prospective cohort study is to investigate the association between
total serum levels of p-cresol and the glomerular filtration rate. The correlation of level
of p-cresol and morbidity-mortality in CKD patients will be also evaluated.
To determine the relationship, patients of nephrology clinic with a diagnosis of CKD were
enrolled in this prospective study and follow-up for 1-year period. The association between
total and free serum levels of p-cresol and the glomerular filtration rate were evaluated in
CKD patients. The p-cresol level was correlated with other many inflammatory markers (white
blood cell counts, ferritin, hs-crp, leptin) and also with the hospitalization rate
secondary to cardiovascular and infectious event. The renal outcome and all-cause mortality
was assessed. Determination of this relationship can help to establish an accurate marker
for early detection of CKD and also its prognostic role in CKD patients.
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