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Toxins
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Uremic Toxins Lowering Strategies in Chronic Kidney Disease
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Uremic Toxins Lowering Strategies in Chronic Kidney Disease

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Uremic Toxins".

Deadline for manuscript submissions: closed (30 August 2022) | Viewed by 8425

Special Issue Editor

Prof. Dr. Suguru Yamamoto

E-Mail Website
Guest Editor
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
Interests: clinical study about uremic toxins-related disease; basic study about uremic toxins-related functional abnormalities of macrophages
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The number of patients with chronic kidney disease (CKD) has increased in the world, and several therapeutic options, including sodium–glucose cotransporter-2 inhibitors and inhibition of the renin–angiotensin aldosterone system are suggested to protect kidney function. However, there are still many end-stage kidney diseases and their clinical outcomes are poor owing to various CKD-related systemic diseases.

Uremic toxins are solutes retained in CKD patients, and their accumulation is associated with various uremic syndromes, including cardiovascular events and infections. Thus, strategies for lowering uremic toxins should be investigated for better clinical outcomes in CKD patients.

This Special Issue is titled Uremic Toxins Lowering Strategies in Chronic Kidney Disease and focuses on investigating strategies to lower uremic toxins as well as to understand the role of those molecules on CKD and its related systemic disorders. This issue welcomes submissions examining this topic with basic or clinical studies on both CKD and dialysis patients.

Prof. Dr. Suguru Yamamoto
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxins is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • uremic toxins
  • chronic kidney disease
  • dialysis
  • transplantation
  • dialysate
  • dialyzer
  • adsorption

Published Papers (5 papers)

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13 pages, 714 KiB  
Article
Body Composition of Healthy Cats and Cats with Chronic Kidney Disease Fed on a Dry Diet Low in Phosphorus with Maintenance Protein
by Daniela P. Machado, Bruna Ruberti, Fabio A. Teixeira, Thiago H. A. Vendramini, Karina Pfrimer, Fernanda C. Chacar, Julio C. C. Balieiro, Cristiana F. F. Pontieri and Marcio A. Brunetto
Toxins 2022, 14(12), 865; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins14120865 - 09 Dec 2022
Viewed by 2174
Abstract
The aim was to evaluate the effect of feeding a low-phosphorus and maintenance protein diet in healthy cats and cats with chronic kidney disease (CKD) with IRIS stages 1 (CKD-1) and 2 (CKD-2). Cats were initially fed a senior diet (30 days) followed [...] Read more.
The aim was to evaluate the effect of feeding a low-phosphorus and maintenance protein diet in healthy cats and cats with chronic kidney disease (CKD) with IRIS stages 1 (CKD-1) and 2 (CKD-2). Cats were initially fed a senior diet (30 days) followed by the renal diet (60 days). Body composition, body weight (BW), muscle mass score (MMS), and body condition score (BCS) were assessed before (T30) and after renal diet intake (T60). General mixed linear models were used to assess the effects of fixed groups and moments (T30 × T60), as well as their interaction, in addition to the random effects of animals within each group. Unlike healthy cats and cats with CKD-1, cats with CKD-2 had a loss of BW, lower BCS (p < 0.005), and lower MMS (p = 0.0008) after 60 days of consuming the renal diet. The fat mass and lean body mass (LBM), determined by the deuterium isotopes method, did not change in all cats between T0 and T60. In healthy cats and cats with CKD-1, the renal diet resulted in maintenance of BW, BCS and MMS; but cats with CKD-2 presented lower BCS and did not reduce phosphatemia after consumption. Full article
(This article belongs to the Special Issue Uremic Toxins Lowering Strategies in Chronic Kidney Disease)
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11 pages, 1910 KiB  
Article
The Medium Cut-Off Membrane Does Not Lower Protein-Bound Uremic Toxins
by Yang Gyun Kim, Sang Ho Lee, Su Woong Jung, Gun Tae Jung, Hyun Ji Lim, Kwang Pyo Kim, Young-Il Jo, KyuBok Jin and Ju Young Moon
Toxins 2022, 14(11), 779; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins14110779 - 10 Nov 2022
Cited by 7 | Viewed by 1628 | Correction
Abstract
The accumulation of protein-bound uremic toxins (PBUT) is associated with increased cardiovascular outcomes in patients on dialysis. However, the efficacy of PBUT removal for a medium-cutoff (MCO) membrane has not been clarified. This study was designed to assess the efficacy of PBUT clearance [...] Read more.
The accumulation of protein-bound uremic toxins (PBUT) is associated with increased cardiovascular outcomes in patients on dialysis. However, the efficacy of PBUT removal for a medium-cutoff (MCO) membrane has not been clarified. This study was designed to assess the efficacy of PBUT clearance according to dialysis modalities. In this prospective and cross-over study, we enrolled 22 patients who received maintenance hemodiafiltration (HDF) thrice weekly from three dialysis centers. The dialysis removal of uremic toxins, including urea, beta 2-microglobulin (B2MG), lambda free light chain (λ-FLC), indoxyl sulfate (IS), and p-cresyl sulfate (pCS), was measured in the 22 patients on high-flux HD (HF-HD), post-dilution online HDF (post-OL-HDF), and MCO-HD over 3 weeks. The average convection volume in post-OL-HDF was 21.4 ± 1.8 L per session. The reduction rate (RR) of B2MG was higher in post-OL-HDF than in MCO-HD and HF-HD. The RR of λ-FLC was the highest in MCO-HD, followed by post-OL-HDF and HF-HD. The dialysate albumin was highest in MCO-HD, followed by post-OL-HDF and HF-HD. Post-dialysis plasma levels of IS and pCS were not statistically different across dialysis modalities. The total solute removal and dialytic clearance of IS and pCS were not significantly different. The clearance of IS and pCS did not differ between the HF-HD, post-OL-HDF, and MCO-HD groups. Full article
(This article belongs to the Special Issue Uremic Toxins Lowering Strategies in Chronic Kidney Disease)
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13 pages, 2703 KiB  
Article
Treatment with Paracetamol Can Interfere with the Intradialytic Optical Estimation in Spent Dialysate of Uric Acid but Not of Indoxyl Sulfate
by Annika Adoberg, Joosep Paats, Jürgen Arund, Annemieke Dhondt, Ivo Fridolin, Griet Glorieux, Jana Holmar, Kai Lauri, Liisi Leis, Merike Luman, Kristjan Pilt, Fredrik Uhlin and Risto Tanner
Toxins 2022, 14(9), 610; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins14090610 - 01 Sep 2022
Cited by 1 | Viewed by 1501
Abstract
Optical online methods are used to monitor the haemodialysis treatment efficiency of end stage kidney disease (ESKD) patients. The aim of this study was to analyse the effect of the administration of UV-absorbing drugs, such as paracetamol (Par), on the accuracy of optical [...] Read more.
Optical online methods are used to monitor the haemodialysis treatment efficiency of end stage kidney disease (ESKD) patients. The aim of this study was to analyse the effect of the administration of UV-absorbing drugs, such as paracetamol (Par), on the accuracy of optical monitoring the removal of uremic toxins uric acid (UA) and indoxyl sulfate (IS) during standard haemodialysis (HD) and haemodiafiltration (HDF) treatments. Nine patients received Par in daily dosages 1–4 g for 30 sessions. For 137 sessions, in 36 patients the total daily dosage of UV-absorbing drugs was less than 500 mg, and for 6 sessions 3 patients received additional UV-absorbing drugs. Par administration slightly affected the accuracy of optically assessed removal of UA expressed as bias between optically and laboratory-assessed reduction ratios (RR) during HD but not HDF employing UV absorbance of spent dialysate (p < 0.05) at 295 nm wavelength with the strongest correlation between the concentration of UA and absorbance. Corresponding removal of IS based on fluorescence at Ex280/Em400 nm during HD and HDF was not affected. Administration of UV-absorbing drugs may in some settings influence the accuracy of optical assessments in spent dialysate of the removal of uremic solutes during haemodialysis treatment of ESKD patients. Full article
(This article belongs to the Special Issue Uremic Toxins Lowering Strategies in Chronic Kidney Disease)
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11 pages, 976 KiB  
Article
Protein/Fiber Index Modulates Uremic Toxin Concentrations in Hemodialysis Patients
by Manon Ebersolt, Tacy Santana Machado, Cecilia Mallmann, Nathalie Mc-Kay, Laetitia Dou, Dammar Bouchouareb, Philippe Brunet, Stéphane Burtey and Marion Sallée
Toxins 2022, 14(9), 589; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins14090589 - 27 Aug 2022
Cited by 4 | Viewed by 1689
Abstract
Background: Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), two uremic toxins (UTs), are associated with increased mortality in patients with chronic kidney disease (CKD). These toxins are produced by the microbiota from the diet and excreted by the kidney. The purpose of this [...] Read more.
Background: Indoxyl sulfate (IS) and p-cresyl sulfate (PCS), two uremic toxins (UTs), are associated with increased mortality in patients with chronic kidney disease (CKD). These toxins are produced by the microbiota from the diet and excreted by the kidney. The purpose of this study was to analyze the effect of diet on IS and PCS concentration in hemodialysis (HD) patients. Methods: We performed a prospective monocentric study using a seven-day diet record and determination of serum IS and PCS levels in HD patients. We tested the association between toxin concentrations and nutritional data. Results: A total of 58/75 patients (77%) completed the diet record. Mean caloric intake was 22 ± 9.2 kcal/kg/day. The protein/fiber index was 4.9 ± 1.8. No correlation between IS or PCS concentration and protein/fiber index was highlighted. In the 18 anuric patients (31%) in whom residual renal function could not affect toxin concentrations, IS and PCS concentrations were negatively correlated with fiber intake and positively correlated with the protein/fiber index. In a multivariate analysis, IS serum concentration was positively associated with the protein/fiber index (p = 0.03). Conclusions: A low protein/fiber index is associated with low concentrations of uremic toxins in anuric HD patients. Diets with an increased fiber intake must be tested to determine whether they reduce PCS and IS serum concentrations. Full article
(This article belongs to the Special Issue Uremic Toxins Lowering Strategies in Chronic Kidney Disease)
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1 pages, 194 KiB  
Correction
Correction: Kim et al. The Medium Cut-Off Membrane Does Not Lower Protein-Bound Uremic Toxins. Toxins 2022, 14, 779
by Yang Gyun Kim, Sang Ho Lee, Su Woong Jung, Gun Tae Jung, Hyun Ji Lim, Kwang Pyo Kim, Young-Il Jo, KyuBok Jin and Ju Young Moon
Toxins 2023, 15(1), 64; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins15010064 - 11 Jan 2023
Viewed by 900
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue Uremic Toxins Lowering Strategies in Chronic Kidney Disease)
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