Sarcopenia is highly prevalent in patients undergoing chronic hemodialysis (HD). This study investigated the relationship among serum indoxyl sulfate (IS) levels, muscle mass, and strength in HD patients. A total of 108 HD patients were enrolled. Skeletal muscle mass and handgrip strength (HGS) were assessed, using bioimpedance analysis and a hand-held dynamometer, respectively. Skeletal muscle index (SMI) was defined as skeletal muscle mass/height² (kg/m²). Serum IS, p-cresol sulfate (PCS), and trimethylamine N-oxide (TMAO) levels were determined using liquid chromatography–mass spectrometry. Patients were classified into two groups based on median serum IS values. HGS measurement was repeated after 2 years. Patients in the high IS group had longer HD duration and higher serum TMAO levels than those in the low IS group. Log-normalized IS level was negatively correlated with SMI (r = − 0.227; p = 0.018), but PCS and TMAO levels were not. Among 78 patients who completed 2-year follow-up, those in the high IS group (n = 41) showed greater absolute (− 2.48 kg versus − 0.25 kg, p = 0.035) and relative HGS loss (− 9.1% versus 1.4%, p = 0.036) than those in the low IS group, after adjustment for potential confounders. Indoxyl sulfate (IS) may play a significant role in uremic sarcopenia. Further large-scale studies are needed to confirm our preliminary findings.

肌肉减少症在接受慢性血液透析（HD）的患者中非常普遍。这项研究调查了HD患者血清中的吲哚酚硫酸盐（IS）水平，肌肉质量和强度之间的关系。共有108名HD患者入组。分别使用生物阻抗分析和手持测功机评估骨骼肌质量和握力（HGS）。骨骼肌指数（SMI）定义为骨骼肌质量/身高²（kg / m ²）。使用液相色谱-质谱法测定血清IS，对甲酚硫酸盐（PCS）和三甲胺N-氧化物（TMAO）的水平。根据中位血清IS值将患者分为两组。2年后重复进行HGS测量。与低IS组相比，高IS组患者的HD持续时间更长，血清TMAO水平更高。对数归一化的IS水平与SMI呈负相关（r  = − 0.227；p  = 0.018），但PCS和TMAO水平则不相关。在78位完成2年随访的患者中，高IS组（n  = 41）的患者显示绝对绝对值更高（-2.48 kg vs--0.25 kg，p  = 0.035）和相对HGS丢失（-9.1％vs 1.4％） ，p 调整为潜在混杂因素后，其值比低IS组低= 0.036）。硫酸吲哚酚（IS）在尿毒症少肌症中可能起重要作用。需要进一步的大规模研究以确认我们的初步发现。