Uremic Toxins and Vascular Dysfunction

Six, Isabelle; Flissi, Nadia; Lenglet, Gaëlle; Louvet, Loı̈c; Kamel, Saı̈d; Gallet, Marlène; Massy, Ziad A.; Liabeuf, Sophie

doi:10.3390/toxins12060404

Cited by 49 publications

(50 citation statements)

References 205 publications

(256 reference statements)

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“…Accordingly, chronic exposure of blood vessels to uremic toxins increases NADPH activity and the ensuing ROS overproduction whilst simultaneously downregulating key antioxidative enzymes such as the endothelial nitrous oxide synthases (eNOS) and superoxide dismutases (SODs). Aberrantly produced ROS act on the cells of the underlying medial layer promoting the osteogenic trans differentiation of VSMCs [reviewed in [ 57 ]]. An additional effect of uremic toxins on ECs is the induction of matrix metalloproteinase 2 and 9 (MMP-2 and -9) and the downregulation of the tissues inhibitors of metalloproteinases 1 and 2 (TIMP-1 and TIMP-2) that result in increased extracellular matrix degradation [ 58 ].…”

Section: Uremic Toxin Mediated Pathways Leading To Vascular Calcifmentioning

confidence: 99%

Role of Uremic Toxins in Early Vascular Ageing and Calcification

Kyriakidis

Cobo²,

Dai

et al. 2021

Toxins

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In patients with advanced chronic kidney disease (CKD), the accumulation of uremic toxins, caused by a combination of decreased excretion secondary to reduced kidney function and increased generation secondary to aberrant expression of metabolite genes, interferes with different biological functions of cells and organs, contributing to a state of chronic inflammation and other adverse biologic effects that may cause tissue damage. Several uremic toxins have been implicated in severe vascular smooth muscle cells (VSMCs) changes and other alterations leading to vascular calcification (VC) and early vascular ageing (EVA). The above mentioned are predominant clinical features of patients with CKD, contributing to their exceptionally high cardiovascular mortality. Herein, we present an update on pathophysiological processes and mediators underlying VC and EVA induced by uremic toxins. Moreover, we discuss their clinical impact, and possible therapeutic targets aiming at preventing or ameliorating the harmful effects of uremic toxins on the vasculature.

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Section: Uremic Toxin Mediated Pathways Leading To Vascular Calcifmentioning

confidence: 99%

Role of Uremic Toxins in Early Vascular Ageing and Calcification

Kyriakidis

Cobo²,

Dai

et al. 2021

Toxins

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“…Uremic toxins can lead to endothelial dysfunction, vascular senescence, vascular inflammation in CKD patients. It is supporting the link between uremic toxins and vascular dysfunction 32 . Silvia D et al demonstrated that uremic toxins impaired the autophagic flux leading to endothelial dysfunction 33 .…”

Section: The Relationship Between Gut Microbiota‐derived Metabolites mentioning

confidence: 77%

Role of gut microbiota‐derived metabolites on vascular calcification in CKD

Yin

Ghosh

et al. 2020

J Cellular Molecular Medi

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The interaction between gut microbiota and the host has gained widespread concern. Gut microbiota not only provides nutrients from the ingested food but also generates bioactive metabolites and signalling molecules to impact host physiology, especially in chronic kidney disease (CKD). The development of CKD, accompanied by changed diet and medication, alters the gut flora and causes the effect in distant organs, leading to clinical complications. Vascular calcification (VC) is an actively regulated process and a high prevalence of VC in CKD has also been linked to an imbalance in gut microbiota and altered metabolites. In this review, we focused on gut microbiota‐derived metabolites involved in VC in CKD and explained how these metabolites influence the calcification process. Correcting the imbalance of gut microbiota and regulating microbiota‐derived metabolites by dietary modification and probiotics are new targets for the improvement of the gut‐kidney axis, which indicate innovative treatment options of VC in CKD.

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“…One mechanism involves the intracellular generation of oxidative stress [ 57 ]. Indeed, it has been reported that exposure to several well-known UTs (including inorganic phosphate, pCS, IxS, and FGF23) leads to vascular dysfunction [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Uremic Toxin Concentrations and Bone Mineral Density after Kidney Transplantation

Batteux

Bodeau

André

et al. 2020

Toxins

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Although uremic osteoporosis is a component of mineral and bone disorder in chronic kidney disease, uremic toxin (UT) concentrations in patients with end-stage kidney disease and bone mineral density (BMD) changes after kidney transplantation have not previously been described. We hypothesized that elevated UT concentrations at the time of transplantation could have a negative impact on bone during the early post-transplantation period. Hence, we sought to determine whether concentrations of UTs (trimethylamine-N-oxide, indoxylsulfate, p-cresylsulfate, p-cresylglucuronide, indole-3-acetic acid, hippuric acid, and 3-carboxy-4-methyl-5-propyl-furanpropionic acid) upon transplantation are predictive markers for (i) osteoporosis one month after transplantation, and (ii) a BMD decrease and the occurrence of fractures 12 and 24 months after kidney transplantation. Between 2012 and 2018, 310 kidney transplant recipients were included, and dual-energy X-ray absorptiometry was performed 1, 12, and 24 months after transplantation. The UT concentrations upon transplantation were determined by reverse-phase high-performance liquid chromatography. Indoxylsulfate concentrations upon transplantation were positively correlated with BMD one month after transplantation for the femoral neck but were not associated with osteoporosis status upon transplantation. Concentrations of the other UTs upon transplantation were not associated with osteoporosis or BMD one month after transplantation. None of the UT concentrations were associated with BMD changes and the occurrence of osteoporotic fractures 12 and 24 months after transplantation. Hence, UT concentrations at the time of kidney transplantation were not predictive markers of osteoporosis or fractures.

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Uremic Toxins and Vascular Dysfunction

Cited by 49 publications

References 205 publications

Role of Uremic Toxins in Early Vascular Ageing and Calcification

Role of Uremic Toxins in Early Vascular Ageing and Calcification

Role of gut microbiota‐derived metabolites on vascular calcification in CKD

Association between Uremic Toxin Concentrations and Bone Mineral Density after Kidney Transplantation

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