Korelasi Kadar Indoksil Sulfat terhadap Kejadian Penyakit Arteri Perifer pada Pasien Penyakit Ginjal Tahap Akhir yang Menjalani Hemodialisa Regular di Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Background: Chronic kidney disease (CKD) is a major global health issue and is associated with an increased risk of peripheral arterial disease (PAD). Indoxyl sulfate (IS), a protein-bound uremic toxin, has been implicated in the development of cardiovascular complications, including PAD, in CKD patients. Objective: To evaluate the correlation between serum indoxyl sulfate levels and the occurrence of PAD in end-stage CKD patients undergoing regular hemodialysis. Methods: This was an observational analytic study with a cross-sectional design conducted at Haji Adam Malik General Hospital, Medan. A total of 51 CKD patients receiving routine hemodialysis were selected using consecutive sampling. Data collected included demographic characteristics, serum IS levels, and ankle–brachial index (ABI). PAD classification was based on ABI values. Statistical analysis used Pearson or Spearman correlation tests, with significance set at p<0.05. Results: The mean age of participants was 49.35 ± 12.3 years, with 60.7% being male. The average serum IS level was 47.32 ± 29.19 μg/mL, while the mean ABI was 1.34 ± 0.344. PAD classification revealed that three patients (5.9%) had PAD, four patients (7.8%) had borderline findings, 44 patients (86.3%) had normal results, and five patients (9.8%) had arterial calcification. Bivariate analysis revealed no significant correlation between serum IS levels and the occurrence of PAD (p > 0.05). Conclusion: No significant association was found between serum indoxyl sulfate levels and PAD in CKD patients undergoing hemodialysis. Further longitudinal studies with larger sample sizes are needed to understand better the role of indoxyl sulfate in PAD development among this population.