In:
Blood Purification, S. Karger AG, Vol. 50, No. 6 ( 2021), p. 837-847
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Elevated levels of serum trimethylamine N-oxide (TMAO) have been previously linked to adverse cardiovascular (CV) and all-cause mortality in hemodialysis patients. However, the clinical significance of serum TMAO levels in patients treated with peritoneal dialysis (PD) is unclear. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 1,032 PD patients with stored serum samples at baseline were enrolled in this prospective study. Serum concentrations of TMAO were quantified by ultra-performance liquid chromatography-tandem mass spectrometry. Cox proportional hazards and competing-risk regression models were performed to examine the association of TMAO levels with all-cause and CV mortality. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The median level of serum TMAO in our study population was 34.5 (interquartile range (IQR), 19.8–61.0) μM. During a median follow-up of 63.7 months (IQR, 43.9–87.2), 245 (24%) patients died, with 129 (53%) deaths resulting from CV disease. In the entire cohort, we observed an association between elevated serum TMAO levels and all-cause mortality (adjusted subdistributional hazard ratio [SHR], 1.22; 95% confidence interval [95% CI] , 1.01–1.48; 〈 i 〉 p 〈 /i 〉 = 0.039) but not CV mortality. Further analysis revealed such association differed by sex; the elevation of serum TMAO levels was independently associated with increased risk of both all-cause (SHR, 1.37; 95% CI, 1.07–1.76; 〈 i 〉 p 〈 /i 〉 = 0.013) and CV mortality (SHR, 1.41; 95% CI, 1.02–1.94; 〈 i 〉 p 〈 /i 〉 = 0.038) in men but not in women. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Higher serum TMAO levels were independently associated with all-cause and CV mortality in male patients treated with PD.
Type of Medium:
Online Resource
ISSN:
0253-5068
,
1421-9735
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
1482025-0
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