Protein-Bound Uremic Toxins from Gut Microbiota and Inflammatory Markers in Chronic Kidney Disease

Borges, Natália Alvarenga; Barros, Amanda F.; Nakao, Lia S.; Dolenga, Carla Juliana Ribeiro; Fouque, Denis; Mafra, Denise

doi:10.1053/j.jrn.2016.07.005

Cited by 77 publications

(42 citation statements)

References 30 publications

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“…Therefore, IS can induce adipocyte perturbation and promote inflammatory state mainly through the induction of oxidative stress [47] . In fact, we recently showed that IS and IAA were associated with higher IL-6 and monocyte chemoattractant protein-1 expression (MCP-1) in CKD patients, potentially playing a role in the development of CVD [48] .…”

Section: Uremic Toxins Derived From Tryptophan Metabolismmentioning

confidence: 99%

Aryl Hydrocarbon Receptor Activation in Chronic Kidney Disease: Role of Uremic Toxins

Brito¹,

Borges²,

Esgalhado³

et al. 2017

Nephron

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The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor involved in the expression of xenobiotic-metabolizing enzymes, inflammatory cytokines and adhesion molecules. Uremic toxins such as indoxyl sulfate and indole acetic acid are derived from tryptophan fermentation by gut microbiota; they accumulate in patients with chronic kidney disease (CKD) on haemodialysis and have recently emerged as potent ligands of AhR. Therefore, AhR can serve as a mediator in inflammation and cardiovascular diseases in these patients. This review discusses current data that support a link between AhR activation and uremic toxins from gut microbiota in CKD.

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Section: Uremic Toxins Derived From Tryptophan Metabolismmentioning

confidence: 99%

Aryl Hydrocarbon Receptor Activation in Chronic Kidney Disease: Role of Uremic Toxins

Brito¹,

Borges²,

Esgalhado³

et al. 2017

Nephron

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“…The influence of such bacterially secreted molecules is larger than previously suspected. Thus, higher plasma levels or uremic toxins of gut origin were associated with evidence of more severe systemic inflammation in CKD patients [16]. The gut microbiota impacts host metabolism and is thought to play a key role in obesity, insulin resistance and cancer, among others [17].…”

Section: The Microbiotamentioning

confidence: 99%

Nutrients Turned into Toxins: Microbiota Modulation of Nutrient Properties in Chronic Kidney Disease

et al. 2017

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In chronic kidney disease (CKD), accumulation of uremic toxins is associated with an increased risk of death. Some uremic toxins are ingested with the diet, such as phosphate and star fruit-derived caramboxin. Others result from nutrient processing by gut microbiota, yielding precursors of uremic toxins or uremic toxins themselves. These nutrients include l-carnitine, choline/phosphatidylcholine, tryptophan and tyrosine, which are also sold over-the-counter as nutritional supplements. Physicians and patients alike should be aware that, in CKD patients, the use of these supplements may lead to potentially toxic effects. Unfortunately, most patients with CKD are not aware of their condition. Some of the dietary components may modify the gut microbiota, increasing the number of bacteria that process them to yield uremic toxins, such as trimethylamine N-Oxide (TMAO), p-cresyl sulfate, indoxyl sulfate and indole-3 acetic acid. Circulating levels of nutrient-derived uremic toxins are associated to increased risk of death and cardiovascular disease and there is evidence that this association may be causal. Future developments may include maneuvers to modify gut processing or absorption of these nutrients or derivatives to improve CKD patient outcomes.

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“…Moreover, the accumulation of these toxins in individuals with CKD has been associated with progression of CKD [12], inflammation [98,111], cardiovascular disease [11], vascular calcification [13], and mortality from cardiovascular disease and from all causes [13,14,112,113].…”

Section: Gut Ecosystem In Ckd and Uremic Toxinsmentioning

confidence: 99%

The cross-talk between the kidney and the gut: implications for chronic kidney disease

Andrade

Ramos

Cuppari

2017

Nutrire

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In recent decades, special attention has been given to the potential association between the gut ecosystem and chronic diseases. Several features and complications of chronic kidney disease (CKD) may induce an unbalanced gut environment, leading to unfavorable consequences for a patient's health. The first section of this review is dedicated to a description of some aspects of gut microbiota and intestinal barrier physiology. The following section explores the impact of CKD on the gut ecosystem and intestinal barrier, particularly the association with uremic toxins, inflammation, and immunodeficiency. Finally, the review describes the state of the art of potential therapies with prebiotics, probiotics, and synbiotics employed to modulate the gut environment and to reduce the generation of colon-derived uremic toxins in CKD.

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Protein-Bound Uremic Toxins from Gut Microbiota and Inflammatory Markers in Chronic Kidney Disease

Cited by 77 publications

References 30 publications

Aryl Hydrocarbon Receptor Activation in Chronic Kidney Disease: Role of Uremic Toxins

Aryl Hydrocarbon Receptor Activation in Chronic Kidney Disease: Role of Uremic Toxins

Nutrients Turned into Toxins: Microbiota Modulation of Nutrient Properties in Chronic Kidney Disease

The cross-talk between the kidney and the gut: implications for chronic kidney disease

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