Correlation between Serum Endotoxin,D-lactate and Enterogenic Uremic Toxins in Chronic Kidney Disease
10.11969/j.issn.1673-548X.2024.10.024
- VernacularTitle:血清内毒素、D-乳酸与慢性肾脏病肠源性尿毒症毒素的相关性研究
- Author:
Qian ZHANG
1
;
Tongxia LI
;
Xiangyu LI
Author Information
1. 100102 北京,中国中医科学院望京医院
- Keywords:
Indoxyl sulfate;
Intestinal barrier;
Chronic kidney disease;
Endotoxins;
D-lactate
- From:
Journal of Medical Research
2024;53(10):134-139
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the correlation between two indicators of the intestinal barrier(i.e.,serum endotoxins and D-lac-tate)and enterogenic uremic toxins,including indoxyl sulfate(IS)and urea nitrogen,in patients with chronic kidney disease(CKD).Methods A total of 260 CKD patients were selected from outpatients and inpatients of the Department of Nephrology and Endocrinology,Wangjing Hospital,China Academy of Traditional Chinese Medicine,from April 2019 to August 2021,and were divided into the CKD stage 3 group(n=51),the CKD stage 4 group(n=130),and the CKD stage 5 group(n=79),according to CKD stage.Patients'age,gender,disease duration,and past medical history were recorded.Serum IS,urea nitrogen,serum endotoxin,D-lactate,and blood cre-atinine were detected.The estimated glomerular filtration rate(eGFR)was calculated.Patients'faeces were retained to detect the levels of Escherichia coli and Bifidobacterium bifidum colonies.The correlation between serum endotoxin and D-lactate and enterogenic uremic toxins was analyzed.Results Comparison of general data:There were no significant differences in age,gender,course of disease,previ-ous diabetes mellitus,and bifidobacteria levels between the three groups(P>0.05),but there were significant differences in pre-exist-ing hypertension and coronary heart disease,IS,serum creatinine,urea nitrogen,eGFR,serum endotoxin,D-lactate acid,and E.coli(P<0.05).Correlation analysis:Spearman analysis showed that serum endotoxin and D-lactate were significantly positively correlated with IS,urea nitrogen,and serum creatinine(P<0.05),and negatively correlated with eGFR(P<0.05).The results of Pearson analy-sis showed that serum endotoxin and D-lactate were significantly positively correlated with E.coli and Bifidobacterium(P<0.05).Mul-tivariate linear regression analysis showed that IS was the independent influencing factor of serum endotoxin(P<0.001)and IS and urea nitrogen were the independent influencing factors of D-lactate(P<0.05).Conclusion Elevated serum endotoxin and D-lactate lev-els in patients with CKD are associated with enterogenic uremic toxins.