Teng-Hung Yu1, Wei-Hua Tang2, Yung-Chuan Lu3, Chao-Ping Wang4, Wei-Chin Hung1, Cheng-Ching Wu1, I-Ting Tsai5, Fu-Mei Chung1, Jer-Yiing Houng6, Wen-Chun Lan7, Yau-Jiunn Lee8. 1. Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan. 2. Division of Cardiology, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan 26058, Taiwan. 3. Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine for International Students, Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 82445, Taiwan. 4. Division of Cardiology, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan; School of Medicine for International Students, Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 82445, Taiwan. 5. Department of Emergency, E-Da Hospital, I-Shou University, Kaohsiung 82445, Taiwan. 6. Department of Nutrition, Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 82445, Taiwan. 7. Lee's Endocrinologic Clinic, Pingtung 90000, Taiwan. 8. Lee's Endocrinologic Clinic, Pingtung 90000, Taiwan. Electronic address: lee@leesclinic.org.
Abstract
BACKGROUND: Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end-stage renal disease. Hippuric acid (HA), a harmful uremic toxin, is known to be elevated in patients with uremia, and serum HA levels are associated with neurological symptoms, metabolic acidosis, and accelerated renal damage associated with chronic kidney disease. However, the pathophysiological role of HA in patients with uremia remains unclear. We investigated the association between serum HA levels and echocardiographic measurements in patients undergoing hemodialysis (HD) treatment. METHODS: Eighty consecutive patients treated at a single HD center (44 males, 36 females; mean age 66 y, mean HD duration 6 y) were included in this study. Comprehensive echocardiography was performed after HD. Blood samples were obtained before HD. RESULTS: Pearson's correlation analysis revealed that serum HA levels were positively correlated with diastolic blood pressure, serum creatinine, left ventricular mass index, end diastolic interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular end systolic diameter, end systolic left ventricular posterior wall thickness, and left atrium diameter, and negatively correlated with age. Furthermore, the HD patients with LVH had higher median serum HA levels than those without LVH (34.2 vs. 18.1 μg/ml, p = 0.003). Multiple logistic regression analysis revealed that HA was independently associated with LVH even after adjusting for known biomarkers. Moreover, the receiver operator characteristics curve of HA showed that a HA level of >26.9 μg/ml was associated with LVH. CONCLUSIONS: HA was significantly associated with LVH. HA could be a novel biomarker of left ventricular overload, which is closely associated with an increased risk of death in HD patients.
BACKGROUND:Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end-stage renal disease. Hippuric acid (HA), a harmful uremic toxin, is known to be elevated in patients with uremia, and serum HA levels are associated with neurological symptoms, metabolic acidosis, and accelerated renal damage associated with chronic kidney disease. However, the pathophysiological role of HA in patients with uremia remains unclear. We investigated the association between serum HA levels and echocardiographic measurements in patients undergoing hemodialysis (HD) treatment. METHODS: Eighty consecutive patients treated at a single HD center (44 males, 36 females; mean age 66 y, mean HD duration 6 y) were included in this study. Comprehensive echocardiography was performed after HD. Blood samples were obtained before HD. RESULTS: Pearson's correlation analysis revealed that serum HA levels were positively correlated with diastolic blood pressure, serum creatinine, left ventricular mass index, end diastolic interventricular septal thickness, left ventricular end-diastolic diameter, left ventricular end systolic diameter, end systolic left ventricular posterior wall thickness, and left atrium diameter, and negatively correlated with age. Furthermore, the HDpatients with LVH had higher median serum HA levels than those without LVH (34.2 vs. 18.1 μg/ml, p = 0.003). Multiple logistic regression analysis revealed that HA was independently associated with LVH even after adjusting for known biomarkers. Moreover, the receiver operator characteristics curve of HA showed that a HA level of >26.9 μg/ml was associated with LVH. CONCLUSIONS:HA was significantly associated with LVH. HA could be a novel biomarker of left ventricular overload, which is closely associated with an increased risk of death in HDpatients.
Authors: Joana Krämer; Rui Kang; Laura M Grimm; Luisa De Cola; Pierre Picchetti; Frank Biedermann Journal: Chem Rev Date: 2022-01-07 Impact factor: 60.622
Authors: Maren Gesper; Alena B H Nonnast; Nina Kumowski; Robert Stoehr; Katharina Schuett; Nikolaus Marx; Ben A Kappel Journal: Front Med (Lausanne) Date: 2021-03-22