Work

#1373 The role of uremic toxins and inflammation in eryptosis and renal anemia among dialysis patients

Year: 2025

Type: article

Abstract: Background and Aims Elevated levels of uremic toxins (UT) and inflammatory cytokines have been implicated in increased eryptosis, a form of premature erythrocyte death, potentially contributing to renal anemia. This study explores the interplay between UT, eryptosis, inflammation, and cytokines with anemia in dialysis patients. Method In this observational cross-sectional study, with approval from the institutional ethics committee, we analyzed blood samples from 41 chronic dialysis patients. Anemia was defined as hemoglobin (Hb) levels below 12 g/dL. Eryptosis was assessed in erythrocytes using Annexin-V to detect phosphatidylserine (PS) exposure. ELISA measured serum cytokine levels (IL-6, IL-1β, IFN-g), and HPLC quantified UT p-cresyl sulfate (pCS) and indole-3-acetic acid (IAA). Correlations were evaluated using Spearman's test, and simple linear regression determined slopes and intercepts. Results No significant results were observed in correlation with IS. However, Hb levels were inversely correlated with pCS (Fig. 1A). Increased PS exposure was positively correlated with pCS levels (Fig. 1B). Furthermore, pCS levels directly correlated with the pro-inflammatory cytokines IL-6 and IFN-g (Fig. 1C and D), while IAA positively correlated with IL-1β levels (Fig. 1E). Conclusion These findings highlight that UT, particularly pCS and IAA, contribute to renal anemia by driving eryptosis and inflammation. Correlations between elevated UT, eryptosis markers, and pro-inflammatory cytokines indicate a mechanism linking uremic toxicity to eryptosis and lower Hb levels. Targeting UT, specifically pCS and IAA and inflammation, may offer a therapeutic approach to mitigate renal anemia in dialysis patients.

Source: Nephrology Dialysis Transplantation

DOI: 10.1093/ndt/gfaf116.0415