In acute renal failure evalotion of p-cresyl sülfat sulfate and indoxyl sulfate levels before and after treatment

ABSTRACT Introduction: This study was planned to evaluate p-cresyl sulfate (pCS) and indoxyl sulfate (IS) levels before and after treatment in patients who developed AKI due to various etiological causes. It is aimed to evaluate whether the course of AKI is related to change in plasma levels of the molecules mentioned. Materials and Methods: The study was conducted with 43 patients diagnosed with AKI. The same patients were evaluated again 3 months after improvement of their renal functions. Serum pCS and IS levels of the patients were evaluated at the time of diagnosis and after treatment. Results: After treatment, a statistically significant decrease in serum urea, creatinine, spot urine protein/creatinine ratio, phosphorus, C-reactive protein (CRP) and leukocyte, neutrophil count and neutrophil/lymphocyte ratio; and a statistically significant increase in glomerular filtration rate (GFR), urine pH and albumin levels in patients were observed. A statistically significant decrease was observed in serum pCS and IS levels after treatment. It was found that the presence of comorbidities was not associated with serum pCS and IS levels. When the patients were evaluated according to RIFLE stages, a statistically significant progression was observed in the serum levels of these molecules from stage R through to stage F at the time of diagnosis; a statistically significant decrease was observed in their post-treatment levels. There was a statistically significant decrease in the serum pCS level in the I and F stages and in the serum IS level in the F stage. A significant decrease in serum pCS level was observed after treatment in patients with a diagnosed prerenal and postrenal AKI. After treatment, a significant decrease in serum pCS level was detected in patients without comorbidities (diabetes mellitus (DM), coronary artery disease (CAD), heart failure (HF), malignancy) compared to patients with comorbidities; a statistically significant decrease was detected in patients with hypertension compared to patients without it. Serum IS levels were significantly decreased in patients without comorbidities compared to patients with comorbidities. Conclusion: A positive correlation was found between severity of acute kidney injury and serum pCS and IS levels. After improvement in AKI, a significant decrease was found in serum pCS and IS levels. In the light of this information, it is thought that pCS and IS levels may guide the diagnosis and course of the disease in acute kidney injury. Key Words: Acute kidney injury, p-cresyl sulfate, indoxyl sulfate