Abstract
Background
The relationship between renal disease and cardiovascular disease (CVD) is currently known as cardiorenal syndrome. Indoxyl sulfate (IS) is one of the uremic toxins that accelerates the progression of cardiorenal syndrome. This report presents a new method for measuring IS in a simpler way.
Methods
We evaluated the analytical performance of an IS Assay Kit “NIPRO” loaded on LABOSPECT 008. The evaluated analytical performances included accuracy, precision, dilution linearity, limit of detection (LOD), limit of quantitation (LOQ), recovery test, interference test and comparison against assays performed by high-performance liquid chromatography (HPLC).
Results
Total precision showed a <5.3% coefficient of variation at IS concentrations of 3.57–277.73 μmol/L, and satisfactory results were observed in the dilution linearity, LOD, LOQ, recovery and interference tests. The IS Assay Kit “NIPRO” showed a high correlation with the HPLC conventional method (r = 0.993).
Conclusions
The IS Assay Kit “NIPRO” demonstrated satisfactory analytical performance, and this suggests it could shortly become another common method to measure circulating IS.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: Y.F., J.T., Y.O., T.I. and S.U. have no conflict of interest. T.M. received a research grant from NIPRO.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Deguchi T, Ohtsuki S, Otagiri M, Takanaga H, Asaba H, Mori S, et al. Major role of organic anion transporter 3 in the transport of indoxyl sulfate in the kidney. Kidney Int 2002;61:1760–8.10.1046/j.1523-1755.2002.00318.xSearch in Google Scholar PubMed
2. Lekawanvijit S, Kompa AR, Wang BH, Kelly DJ, Krum H. Cardiorenal syndrome: the emerging role of protein-bound uremic toxins. Circ Res 2012;111:1470–83.10.1161/CIRCRESAHA.112.278457Search in Google Scholar PubMed
3. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease. Circulation 2003;108:2154–69.10.1161/01.CIR.0000095676.90936.80Search in Google Scholar PubMed
4. Namba S, Okuda Y, Sano M, Kojima T, Morimoto A, Watanabe I, et al. Indoxyl sulfate is an independent risk factor for coronary heart disease in patients with chronic kidney disease. Int J Anal Bio-Sci 2014;2:52–7.Search in Google Scholar
5. Niwa T. Indoxyl sulfate is a nephro-vascular toxin. J Ren Nutr 2010;20–5S:S2–6.10.1053/j.jrn.2010.05.002Search in Google Scholar PubMed
6. Niwa T. Uremic toxicity of indoxyl sulfate. Nagoya J Med Sci 2010;72:1–11.Search in Google Scholar
7. Barreto FC, Barreto DV, Liabeuf S, Meert N, Glorieux G, Temmar M, et al. Serum indoxyl sulfate is associated with vascular disease and mortality in chronic kidney disease patients. CJASN 2009;4–10:1551–8.10.2215/CJN.03980609Search in Google Scholar PubMed PubMed Central
8. Dou L, Bertrand E, Cerini C, Faure V, Sampol J, Vanholder R, et al. The uremic solutes p-cresol and indoxyl sulfate inhibit endothelial proliferation and wound repair. Kidney Int 2004;65:442–51.10.1111/j.1523-1755.2004.00399.xSearch in Google Scholar PubMed
9. Koizumi M, Tatebe J, Watanabe I, Yamazaki J, Ikeda T, Morita T. Aryl hydrocarbon receptor mediates indoxyl sulfate-induced cellular senescence in human umbilical vein endothelial cells. J Atheroscler Thromb 2014;21:904–16.10.5551/jat.23663Search in Google Scholar PubMed
10. Masai N, Tatebe J, Yoshino G, Morita T. Indoxyl sulfate stimulates monocyte chemoattractant protein-1 expression in human umbilical vein endothelial cells by inducing oxidative stress through activation of the NADPH oxidase-nuclear-factor-κB pathway. Circ J 2010;74:2216–24.10.1253/circj.CJ-10-0117Search in Google Scholar PubMed
11. Watanabe I, Tatebe J, Namba S, Koizumi M, Yamazaki J, Morita T. Activation of aryl hydrocarbon receptor mediates indoxyl sulfate-induced monocyte chemoattractant protein-1 expression in human umbilical vein endothelial cells. Circ J 2013;77:224–30.10.1253/circj.CJ-12-0647Search in Google Scholar PubMed
12. Tumur Z, Niwa T. Indoxyl sulfate inhibits nitric oxide production and cell viability by inducing oxidative stress in vascular endothelial cells. Am J Nephrol 2009;29:551–7.10.1159/000191468Search in Google Scholar PubMed
13. Watanabe I, Tatebe J, Fujii T, Noike R, Saito D, Koike H, et al. Prognostic utility of indoxyl sulfate for patients with acute coronary syndrome. J Atheroscler Thromb 2019;26:64–71.10.5551/jat.44149Search in Google Scholar PubMed PubMed Central
14. Niwa T, Takeda N, Tatematsu A, Maeda K. Accumulation of indoxyl sulfate, an inhibitor of drug-binding, in uremic serum as demonstrated by internal-surface reversed-phase liquid chromatography. Clin Chem 1988;34:2264–7.10.1093/clinchem/34.11.2264Search in Google Scholar
15. Yamaoto Y, Hosogaya S, Kuwa K, Osawa S, Takagi Y, Miyake K, et al. Guideline for the validation of quantitative measurement methods. Jpn J Clin Chem 2011;40:149–57.Search in Google Scholar
16. Ichihara K, Hosogaya S, Okutani S, Itoh K, Kameko M, Kayamori Y, et al. Protocols of determining limits of detection and limits of quantitation for quantitative analytical methods. Jpn J Clin Chem 2006;35:280–90.Search in Google Scholar
17. Japan association of medical technologists. Evaluation of precision and accuracy performance for quantitative routine methods in clinical chemistry. JJCCLS 1999;14–2:3–26Search in Google Scholar
18. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307–10.10.1016/j.ijnurstu.2009.10.001Search in Google Scholar
19. Shafi T, Sirich TL, Meyer TW, Hostetter TH, Plummer NS, Hwang S, et al. Results of the HEMO Study suggest that p-cresol sulfate and indoxyl sulfate are not associated with cardiovascular outcomes. Kidney Int 2017;92–6:1484–92.10.1016/j.kint.2017.05.012Search in Google Scholar PubMed PubMed Central
©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Identification and management of spurious hemolysis: controversies, concerns and criticisms
- Reviews
- CYP24A1 and SLC34A1 genetic defects associated with idiopathic infantile hypercalcemia: from genotype to phenotype
- Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria?
- Opinion Paper
- Collection, transport and storage procedures for blood culture specimens in adult patients: recommendations from a board of Italian experts
- General Clinical Chemistry and Laboratory Medicine
- Using the hemoglobin-binding Staphylococcus aureus protein IsdH to enable plasma analysis of hemolyzed blood samples
- Handling of hemolyzed serum samples in clinical chemistry laboratories: the Nordic hemolysis project
- Clinical biomarker innovation: when is it worthwhile?
- Impact of total automation consolidating first-line laboratory tests on diagnostic blood loss
- Diagnostic and prognostic value of the D-dimer test in emergency department patients: secondary analysis of an observational study
- Screening of chemical libraries in pursuit of kallikrein-5 specific inhibitors for the treatment of inflammatory dermatoses
- Comparison of five automated urine sediment analyzers with manual microscopy for accurate identification of urine sediment
- Establishment of an international autoantibody reference standard for human anti-DFS70 antibodies: proof-of-concept study for a novel Megapool strategy by pooling individual specific sera
- Only monospecific anti-DFS70 antibodies aid in the exclusion of antinuclear antibody associated rheumatic diseases: an Italian experience
- Performance evaluation of an Indoxyl Sulfate Assay Kit “NIPRO”
- Variable and inaccurate serum IgG4 levels resulting from lack of standardization in IgG subclass assay calibration
- Hematology and Coagulation
- Influence of hypertriglyceridemia, hyperbilirubinemia and hemolysis on thrombin generation in human plasma
- Reference Values and Biological Variations
- Reference intervals for serum total vitamin B12 and holotranscobalamin concentrations and their change points with methylmalonic acid concentration to assess vitamin B12 status during early and mid-pregnancy
- Cardiovascular Diseases
- Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients
- Letters to the Editor
- Management of potassium results in haemolysed plasma samples at the emergency department laboratory
- Unexpected analytical interference in isavuconazole UV determination in a child in therapy with lumacaftor/ivacaftor for cystic fibrosis
- Total laboratory automation has the potential to be the field of application of artificial intelligence: the cyber-physical system and “Automation 4.0”
- 99th percentile upper reference limit of AccuTnI+3 in a Korean reference population: a multicenter study using fresh serum
- Roche Troponin T hs-STAT meets all expert opinion analytical laboratory practice recommendations for the use of the differential diagnosis of acute coronary syndrome
- A comparison of biotin interference in routine immunoassays on the Roche Cobas 8000, Beckman Coulter DXi and Siemens Advia Centaur XPT immunoassay platforms
- The importance of the methodology and sample matrix when interpreting chromogranin A results
- The sudden death of the combined first trimester aneuploidy screening, a single centre experience in Belgium
- Reply to Luksic et al. Clin Chem Lab Med 2018;56(4):574–581
Articles in the same Issue
- Frontmatter
- Editorial
- Identification and management of spurious hemolysis: controversies, concerns and criticisms
- Reviews
- CYP24A1 and SLC34A1 genetic defects associated with idiopathic infantile hypercalcemia: from genotype to phenotype
- Meta-analysis: compared with anti-CCP and rheumatoid factor, could anti-MCV be the next biomarker in the rheumatoid arthritis classification criteria?
- Opinion Paper
- Collection, transport and storage procedures for blood culture specimens in adult patients: recommendations from a board of Italian experts
- General Clinical Chemistry and Laboratory Medicine
- Using the hemoglobin-binding Staphylococcus aureus protein IsdH to enable plasma analysis of hemolyzed blood samples
- Handling of hemolyzed serum samples in clinical chemistry laboratories: the Nordic hemolysis project
- Clinical biomarker innovation: when is it worthwhile?
- Impact of total automation consolidating first-line laboratory tests on diagnostic blood loss
- Diagnostic and prognostic value of the D-dimer test in emergency department patients: secondary analysis of an observational study
- Screening of chemical libraries in pursuit of kallikrein-5 specific inhibitors for the treatment of inflammatory dermatoses
- Comparison of five automated urine sediment analyzers with manual microscopy for accurate identification of urine sediment
- Establishment of an international autoantibody reference standard for human anti-DFS70 antibodies: proof-of-concept study for a novel Megapool strategy by pooling individual specific sera
- Only monospecific anti-DFS70 antibodies aid in the exclusion of antinuclear antibody associated rheumatic diseases: an Italian experience
- Performance evaluation of an Indoxyl Sulfate Assay Kit “NIPRO”
- Variable and inaccurate serum IgG4 levels resulting from lack of standardization in IgG subclass assay calibration
- Hematology and Coagulation
- Influence of hypertriglyceridemia, hyperbilirubinemia and hemolysis on thrombin generation in human plasma
- Reference Values and Biological Variations
- Reference intervals for serum total vitamin B12 and holotranscobalamin concentrations and their change points with methylmalonic acid concentration to assess vitamin B12 status during early and mid-pregnancy
- Cardiovascular Diseases
- Serum concentrations of free fatty acids are associated with 3-month mortality in acute heart failure patients
- Letters to the Editor
- Management of potassium results in haemolysed plasma samples at the emergency department laboratory
- Unexpected analytical interference in isavuconazole UV determination in a child in therapy with lumacaftor/ivacaftor for cystic fibrosis
- Total laboratory automation has the potential to be the field of application of artificial intelligence: the cyber-physical system and “Automation 4.0”
- 99th percentile upper reference limit of AccuTnI+3 in a Korean reference population: a multicenter study using fresh serum
- Roche Troponin T hs-STAT meets all expert opinion analytical laboratory practice recommendations for the use of the differential diagnosis of acute coronary syndrome
- A comparison of biotin interference in routine immunoassays on the Roche Cobas 8000, Beckman Coulter DXi and Siemens Advia Centaur XPT immunoassay platforms
- The importance of the methodology and sample matrix when interpreting chromogranin A results
- The sudden death of the combined first trimester aneuploidy screening, a single centre experience in Belgium
- Reply to Luksic et al. Clin Chem Lab Med 2018;56(4):574–581