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Uremic Apelin and Leucocytic Angiotensin-Converting Enzyme 2 in CKD Patients
Review

Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets

1
Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 3K7, Canada
2
Division of Nephrology, Department of Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 3K7, Canada
3
Lawson Health Research Institute, London, ON N6A 3K7, Canada
*
Author to whom correspondence should be addressed.
Received: 22 December 2020 / Revised: 8 February 2021 / Accepted: 10 February 2021 / Published: 13 February 2021
(This article belongs to the Special Issue Uremic Toxin-Mediated Mechanisms in Cardiovascular and Renal Disease)
Chronic kidney disease (CKD) is a progressive loss of renal function. The gradual decline in kidney function leads to an accumulation of toxins normally cleared by the kidneys, resulting in uremia. Uremic toxins are classified into three categories: free water-soluble low-molecular-weight solutes, protein-bound solutes, and middle molecules. CKD patients have increased risk of developing cardiovascular disease (CVD), due to an assortment of CKD-specific risk factors. The accumulation of uremic toxins in the circulation and in tissues is associated with the progression of CKD and its co-morbidities, including CVD. Although numerous uremic toxins have been identified to date and many of them are believed to play a role in the progression of CKD and CVD, very few toxins have been extensively studied. The pathophysiological mechanisms of uremic toxins must be investigated further for a better understanding of their roles in disease progression and to develop therapeutic interventions against uremic toxicity. This review discusses the renal and cardiovascular toxicity of uremic toxins indoxyl sulfate, p-cresyl sulfate, hippuric acid, TMAO, ADMA, TNF-α, and IL-6. A focus is also placed on potential therapeutic targets against uremic toxicity. View Full-Text
Keywords: uremic toxins; chronic kidney disease; cardiovascular disease; indoxyl sulfate; p-cresyl sulfate; hippuric acid; trimethylamine N-oxide; asymmetric dimethylarginine; tumor necrosis factor al-pha; interleukin 6 uremic toxins; chronic kidney disease; cardiovascular disease; indoxyl sulfate; p-cresyl sulfate; hippuric acid; trimethylamine N-oxide; asymmetric dimethylarginine; tumor necrosis factor al-pha; interleukin 6
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MDPI and ACS Style

Lim, Y.J.; Sidor, N.A.; Tonial, N.C.; Che, A.; Urquhart, B.L. Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets. Toxins 2021, 13, 142. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13020142

AMA Style

Lim YJ, Sidor NA, Tonial NC, Che A, Urquhart BL. Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets. Toxins. 2021; 13(2):142. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13020142

Chicago/Turabian Style

Lim, Yong J.; Sidor, Nicole A.; Tonial, Nicholas C.; Che, Adrian; Urquhart, Bradley L. 2021. "Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets" Toxins 13, no. 2: 142. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13020142

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