Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease
Patients with chronic kidney disease (CKD), especially those undergoing hemodialysis, are at a considerably high risk of bone fracture events. Experimental data indicate that uremic toxins intricately involved in bone-related proteins exert multi-faced toxicity on bone cells and tissues, leading to...
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MDPI AG
2021-07-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/13/7/479 |
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| author | Jia-Feng Chang Chih-Yu Hsieh Jian-Chiun Liou Kuo-Cheng Lu Cai-Mei Zheng Mai-Szu Wu Shu-Wei Chang Ting-Ming Wang Chang-Chin Wu |
| author_facet | Jia-Feng Chang Chih-Yu Hsieh Jian-Chiun Liou Kuo-Cheng Lu Cai-Mei Zheng Mai-Szu Wu Shu-Wei Chang Ting-Ming Wang Chang-Chin Wu |
| author_sort | Jia-Feng Chang |
| collection | DOAJ |
| description | Patients with chronic kidney disease (CKD), especially those undergoing hemodialysis, are at a considerably high risk of bone fracture events. Experimental data indicate that uremic toxins intricately involved in bone-related proteins exert multi-faced toxicity on bone cells and tissues, leading to chronic kidney disease–mineral and bone disorder (CKD-MBD). Nonetheless, information regarding the association between <i>p</i>-cresyl sulfate (PCS), non-hepatic alkaline phosphatase (NHALP) and skeletal events remains elusive. We aim to explore the association between PCS, NHALP and risk of bone fracture (BF) in patients with hemodialysis. Plasma concentrations of PCS and NHALP were ascertained at study entry. Cox proportional hazard regression analyses were used to determine unadjusted and adjusted hazard ratios (aHRs) of PCS for BF risk. In multivariable analysis, NHALP was associated with incremental risks of BFs [aHR: 1.06 (95% CI: 1.01–1.11)]. The association between the highest PCS tertile and BF risk remained robust [aHR: 2.87 (95% CI: 1.02–8.09)]. With respect to BF events, the interaction between NHALP and PCS was statistically significant (<i>p</i> value for the interaction term < 0.05). In addition to mineral dysregulation and hyperparathyroidism in hemodialysis patients, higher circulating levels of PCS and NHALP are intricately associated with incremental risk of BF events, indicating that a joint evaluation is more comprehensive than single marker. In light of the extremely high prevalence of CKD-MBD in the hemodialysis population, PCS may act as a pro-osteoporotic toxin and serve as a potential surrogate marker for skeletal events. |
| first_indexed | 2024-03-10T09:20:47Z |
| format | Article |
| id | doaj.art-604e0840521e4f02af16af49f040551d |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T09:20:47Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-604e0840521e4f02af16af49f040551d2023-11-22T05:10:54ZengMDPI AGToxins2072-66512021-07-0113747910.3390/toxins13070479Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone DiseaseJia-Feng Chang0Chih-Yu Hsieh1Jian-Chiun Liou2Kuo-Cheng Lu3Cai-Mei Zheng4Mai-Szu Wu5Shu-Wei Chang6Ting-Ming Wang7Chang-Chin Wu8Division of Nephrology, Department of Internal Medicine, En Chu Kong Hospital, New Taipei City 237, TaiwanSchool of Biomedical Engineering, Taipei Medical University, Taipei 110, TaiwanSchool of Biomedical Engineering, Taipei Medical University, Taipei 110, TaiwanDivision of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, TaiwanDivision of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, TaiwanDivision of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, TaiwanDepartment of Civil Engineering, National Taiwan University, Taipei 106, TaiwanDepartment of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei 100, TaiwanDepartment of Orthopaedic Surgery, National Taiwan University Hospital, Taipei 100, TaiwanPatients with chronic kidney disease (CKD), especially those undergoing hemodialysis, are at a considerably high risk of bone fracture events. Experimental data indicate that uremic toxins intricately involved in bone-related proteins exert multi-faced toxicity on bone cells and tissues, leading to chronic kidney disease–mineral and bone disorder (CKD-MBD). Nonetheless, information regarding the association between <i>p</i>-cresyl sulfate (PCS), non-hepatic alkaline phosphatase (NHALP) and skeletal events remains elusive. We aim to explore the association between PCS, NHALP and risk of bone fracture (BF) in patients with hemodialysis. Plasma concentrations of PCS and NHALP were ascertained at study entry. Cox proportional hazard regression analyses were used to determine unadjusted and adjusted hazard ratios (aHRs) of PCS for BF risk. In multivariable analysis, NHALP was associated with incremental risks of BFs [aHR: 1.06 (95% CI: 1.01–1.11)]. The association between the highest PCS tertile and BF risk remained robust [aHR: 2.87 (95% CI: 1.02–8.09)]. With respect to BF events, the interaction between NHALP and PCS was statistically significant (<i>p</i> value for the interaction term < 0.05). In addition to mineral dysregulation and hyperparathyroidism in hemodialysis patients, higher circulating levels of PCS and NHALP are intricately associated with incremental risk of BF events, indicating that a joint evaluation is more comprehensive than single marker. In light of the extremely high prevalence of CKD-MBD in the hemodialysis population, PCS may act as a pro-osteoporotic toxin and serve as a potential surrogate marker for skeletal events.https://www.mdpi.com/2072-6651/13/7/479<i>p</i>-cresyl sulfatealkaline phosphatasebone fracturechronic kidney disease–mineral and bone disorder |
| spellingShingle | Jia-Feng Chang Chih-Yu Hsieh Jian-Chiun Liou Kuo-Cheng Lu Cai-Mei Zheng Mai-Szu Wu Shu-Wei Chang Ting-Ming Wang Chang-Chin Wu Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease Toxins <i>p</i>-cresyl sulfate alkaline phosphatase bone fracture chronic kidney disease–mineral and bone disorder |
| title | Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease |
| title_full | Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease |
| title_fullStr | Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease |
| title_full_unstemmed | Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease |
| title_short | Circulating <i>p</i>-Cresyl Sulfate, Non-Hepatic Alkaline Phosphatase and Risk of Bone Fracture Events in Chronic Kidney Disease-Mineral Bone Disease |
| title_sort | circulating i p i cresyl sulfate non hepatic alkaline phosphatase and risk of bone fracture events in chronic kidney disease mineral bone disease |
| topic | <i>p</i>-cresyl sulfate alkaline phosphatase bone fracture chronic kidney disease–mineral and bone disorder |
| url | https://www.mdpi.com/2072-6651/13/7/479 |
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