Journal of
Clinical Medicine and Research

  • Abbreviation: J. Clin. Med. Res.
  • Language: English
  • ISSN: 2141-2235
  • DOI: 10.5897/JCMR
  • Start Year: 2009
  • Published Articles: 104

Full Length Research Paper

The serum levels of P-cresol and Indoxyl sulfate in different hemodialysis vintage

Cheng-Jui Lin1,3,7, Chih-Kuang Chuang5,6,7, Hsuan-Liang Liu7, Tuen-Jen Wang8, Han-Hsiang Chen1,3, Fang-Ju Sun2,3 and Chih-Jen Wu1,3,4*
1Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. 2Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan. 3Mackay Medicine, Nursing and Management College, Taipei, Taiwan. 4Graduate Institute of Medical Science, Taipei Medical University, Taipei, Taiwan. 5Division of Genetics and Metabolism, Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan. 6 Colleges of Medicine, Fu-Jen Catholic University, Taipei County, Taiwan. 7Institute of Biotechnology, National Taipei University of Technology, 1 Sec. 3 ZhongXiao E. Rd., Taipei, 10608, Taiwan. 8Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Email: [email protected]

  •  Accepted: 25 October 2011
  •  Published: 31 December 2011


Indoxyl sulfate (IS) and para-cresol (p-cresol) belong to the group of protein-bound uremic toxins that are poorly cleared by dialysis and are associated with poor clinical outcomes. The goal of our study was to evaluate the relationship between dialysis time and serum levels of IS and p-cresol in hemodialysis (HD) patients. Our study enrolled 96 stable HD patients who were categorized into 8 subgroups on the basis of the duration for which they received dialysis within a period of 1 year. Patients with acute infection, malignancy or those who were younger than 18 years of age were excluded. Serum levels of total and free p-cresol and indoxyl sulfate were measured using ultra performance liquid chromatography (UPLC). Biochemical data was also collected concurrently. In our study, we found that only unbound IS and total IS were significantly and positively correlated with the dialysis time in HD patients by trend analysis (p= 0.020 and p=0.007, respectively). Other independent variables, including the levels of unbound p-cresol, total p-cresol, hemoglobin, highly sensitive C-reactive protein (CRP), Kt/V and albumin, did not show significant correlation with the length of HD treatment. Our results inferred that patients undergoing longer hemodialsysis may lead to higher serum levels of IS.


Key words: Hemodialysis time, indoxyl sulfate, p-cresol, p-cresyl sulfate and protein-bound uremic toxin.