Blood Purification

Research Article

Elevated Serum Trimethylamine N-Oxide Levels Are Associated with Mortality in Male Patients on Peritoneal Dialysis

Fu D.a,b,c · Shen J.a,b,c · Li W.d · Wang Y.a,b,c · Zhong Z.a,b,c · Ye H.a,b,c · Huang N.a,b,c · Fan L.a,b,c · Yang X.a,b,c · Yu X.a,b,c · Zhou Y.a,b,c · Mao H.a,b,c

Author affiliations

aDepartment of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
bNHC Key Laboratory of Nephrology, Guangzhou, China
cGuangdong Provincial Key Laboratory of Nephrology, Guangzhou, China
dDepartment of Nephrology, First People’s Hospital of Foshan, Foshan, China

Keywords: Trimethylamine N-oxideAll-cause mortalityCardiovascular mortalityPeritoneal dialysisSex differences

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Blood Purif 2021;50:837–847
https://doi.org/10.1159/000512962

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Article / Publication Details

First-Page Preview
Abstract of Research Article

Received: April 15, 2020
Accepted: November 09, 2020
Published online: February 17, 2021
Issue release date: September 2021

Number of Print Pages: 11
Number of Figures: 4
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Background: 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. Methods: 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. Results: 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; p = 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; p = 0.013) and CV mortality (SHR, 1.41; 95% CI, 1.02–1.94; p = 0.038) in men but not in women. Conclusions: Higher serum TMAO levels were independently associated with all-cause and CV mortality in male patients treated with PD.

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Article / Publication Details

First-Page Preview
Abstract of Research Article

Received: April 15, 2020
Accepted: November 09, 2020
Published online: February 17, 2021
Issue release date: September 2021

Number of Print Pages: 11
Number of Figures: 4
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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2021, Vol.50, No. 6

September 2021

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Dongying Fu and Jiani Shen contributed equally to this work.
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