Investigation of S-Equol, indoxyl sulfate, trimethylamine N-oxide levels in serum and urine as a prognosis marker in patients followed with the diagnosis of chronic renal failure

Chronic renal failure (CRF) is a clinical metabolic syndrome characterized by loss of kidney function. CRF is defined as a chronic and progressive deterioration in the kidney's fluid-electrolyte balance and metabolic and endocrine functions as a result of irreversible decrease in glomerular filtration rate (GFR). Currently, the most commonly used parameters for the early diagnosis of CRF are serum creatinine and GFR measurements. In this study, it was aimed to investigate the usability of these parameters in the prognosis of CRF by measuring the levels of S-Equol, Indoxyl sulfate, and Trimethyl Amine Oxide in the sera of healthy controls and case groups who were followed up with CRF and had no disease. The study included 40 pediatric patients aged 5-18 years, who were followed up by the Fırat University Medical Faculty Hospital Pediatric Nephrology outpatient clinic with the diagnosis of CRF, and 40 healthy children, who did not have any disease and did not use medication, as the control group. Demographic data (age, gender), clinical status, laboratory values, treatment regimens used, and complications that may develop or develop of the patients who agreed to participate in the study were recorded. Height, weight and body mass indexes were recorded. During the blood collection from the patients for routine controls, 5 cc of blood was also drawn into the biochemistry tube for once. The bloods were centrifuged and the serums were stored at -20 degrees to be studied after the study was completed. In our study, S-Equol, Indoxyl sulfate and Trimethyl Amine Oxide levels in the serum and urine of healthy controls and patient groups with and without CRF were studied by the Department of Biochemistry of Fırat University. In our study, urinary TMAO (p=0.034), urine S-equol (p<0.001), urine ındoxyl sulfate (p=0.029) and serum TMAO (p=0.007) values were found to be significantly higher than the control group. When the patients in the case group were classified as early stage and advanced CRF, the IS/creatinine value was found to be significantly lower in advanced stage CRF patients compared to early stage CRF patients (p=0.003). Urine ındoxyl sulfate (p=0.01), serum TMAO (p=0.009) and urine TMAO (p<0.001) values were found to be significantly higher in advanced stage CRF patients compared to early stage CRF patients. As a result, in this study, urinary TMAO, urine S-equol, urine ındoxyl sulfate and serum TMAO parameters can be used in the diagnostic evaluation of patients with CRF; It was concluded that IS/creatinine value, urine ındoxyl sulfate, serum TMAO and urine TMAO parameters can be used in staging of CRF. In order to clearly demonstrate the relationship between CRF and existing parameters in studies, large-scale prospective studies are needed. Keywords: Chronic Renal Failure, S-Equol, Indoxyl sulfate, Trimethylamine N-oxide