Phase II metabolism consists of conjugation reactions that produce more polar and less active metabolites, allowing for excretion into the urine or stool.26 These p-cresol cometabolites are positively associated with chronic kidney diseases;27 however, the glomerular filtration rate, an indicator of kidney function, in patients with sAH was only negatively correlated with 4-ethylphenyl sulfate concentrations and not with other sulfate-conjugated microbial metabolites (Supplemental Figure S3, http://links.lww.com/HC9/A560). This evidence concerns the gene ACSM3 and chronic kidney disease.