title: Plasma indoxyl sulfate and estimated glomerular filtration rate.
abstract: BACKGROUND
  Indoxyl sulfate (IS), a uremic toxin, has cardiovascular as well as uremic toxicity. We evaluated the prognostic value of blood IS level for long-term outcome.
  
  
  RESULTS
  This study followed 311 patients with coronary artery disease. Plasma IS level and estimated glomerular filtration rate (eGFR) were determined. The endpoint was a major adverse cardiac event (MACE). Median follow-up was 759 days. IS was significantly higher in patients with MACE than in those without (P<0.001). Patients were divided according to quartiles (Q) of plasma IS level (Q1, Q2, Q3, and Q4). On Kaplan-Meier analysis a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P<0.001). In patients with eGFR ≥90, 89-60, 59-30, 29-15, and <15 ml·min(-1)·1.73 m(-2), the percentage of patients in Q4 was 0%, 13%, 29%, 100%, and 100%, respectively. In patients with eGFR 89-60 ml·min(-1)·1.73 m(-2), there was no significant difference in MACE-free rate between Q4 and the other quartiles; in patients with eGFR 59-30 ml·min(-1)·1.73 m(-2), a significantly lower MACE-free rate was obtained for Q4 compared with the other quartiles (P=0.832 and P=0.015, respectively).
  
  
  CONCLUSIONS
  Plasma IS level is a significant predictor of MACE, especially in patients with eGFR 59-30 ml·min(-1)·1.73 m(-2).
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine.
authors.forename: Daiji
authors.initials: D
authors.lastname: Yoshikawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Takeshita
authors.forename: Soichiro
authors.initials: S
authors.lastname: Kumagai
authors.forename: Mutsuharu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Niwa
authors.forename: Hideo
authors.initials: H
authors.lastname: Izawa
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007200:Indican / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors
chemical_list: D007200:Indican