What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Peritoneal Dialysis (n=82). Intervention: p-Cresyl sulfate (PCS). Primary outcome: Vascular reactivity index (VRI) (p=0.029).

What question did this study set out to answer?

This research aims to clarify the relationship between p-cresyl sulfate levels and endothelial function in patients on peritoneal dialysis.

May 10, 2026Open Access

Elevated p-Cresyl Sulfate Levels Are Associated with Impaired Endothelial Function in Patients Undergoing Long-Term Peritoneal Dialysis

Key Result

Higher serum p-Cresyl sulfate levels were independently associated with poor vascular reactivity in patients undergoing long-term peritoneal dialysis (p=0.029).

Key Points

This research aims to clarify the relationship between p-cresyl sulfate levels and endothelial function in patients on peritoneal dialysis.
Cross-sectional study with 82 patients receiving peritoneal dialysis.
Serum p-cresyl sulfate concentrations measured using high-performance liquid chromatography–mass spectrometry.
Endothelial function assessed by digital thermal monitoring, categorized by vascular reactivity index values.
46.3% of participants had poor vascular reactivity, significantly associated with higher p-cresyl sulfate levels (p < 0.001).
Higher p-cresyl sulfate levels correlated with reduced vascular reactivity index after adjusting for confounders (p < 0.001).
Multivariable analyses indicated an independent association of p-cresyl sulfate with poor vascular reactivity (p = 0.029).

Study Design

Type

Cross-Sectional (n=82)

Structured PICO

Are elevated p-Cresyl sulfate levels associated with impaired endothelial function in patients undergoing long-term peritoneal dialysis?

Population

82 patients receiving long-term peritoneal dialysis

Intervention

Serum p-Cresyl sulfate (PCS) levels

Outcome

Endothelial function evaluated by digital thermal monitoring (DTM) and vascular reactivity index (VRI)surrogate

Elevated serum p-Cresyl sulfate levels are independently associated with impaired endothelial function in patients on long-term peritoneal dialysis.

Main Result

p-value: p=0.029

Abstract

p-Cresyl sulfate (PCS) is associated with endothelial injury and adverse cardiovascular outcomes. However, its association with endothelial function in patients on peritoneal dialysis (PD) remains unclear. In this cross-sectional study, 82 patients receiving PD were enrolled. Serum PCS concentrations were quantified using high-performance liquid chromatography–mass spectrometry. Endothelial function was evaluated by digital thermal monitoring (DTM), and vascular reactivity was stratified based on vascular reactivity index (VRI) values into good (>2.0), intermediate (1.0–1.9), and poor (<1.0). Overall, 46.3%, 43.9%, and 9.8% of participants had poor, intermediate, and good vascular reactivity, respectively. Poor reactivity was associated with a higher prevalence of diabetes (p = 0.018), old age (p < 0.001), higher waist circumference (p = 0.013), serum C-reactive protein levels (p = 0.010), and PCS levels (p < 0.001) and lower diastolic blood pressure (p = 0.032) and serum creatinine levels (p = 0.005). Higher serum log-transformed PCS levels were associated with reduced VRI after adjustment for covariates (p < 0.001). In multivariable models adjusted for potential confounders, PCS was independently associated with poor vascular reactivity (p = 0.029), with consistent findings observed across penalized regression analyses (all p < 0.001). An inverse relationship was observed between serum PCS levels and endothelial function in patients undergoing PD.