Vasculopathy in the setting of cardiorenal syndrome: roles of protein-bound uremic toxins

Guo, Jane; Lu, Lu; Yue, Hua; Huang, Kexuan; Wang, Ian; Huang, Li; Fu, Qiang; Chen, Aihua; Chan, Paul; Fan, Huimin; Liu, Zhong Min; Wang, Bing Hui

doi:10.1152/ajpheart.00787.2016

Cited by 34 publications

(20 citation statements)

References 168 publications

(163 reference statements)

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“…Also, LV function and hypertrophy are known to be correlated with aortic calcification [32]. It can be speculated that vascular calcification may be involved in the pathogenesis of cardiorenal syndrome, as evaluated by the results of the present study [33]. In addition, it is clear that aortic calcification may be a part of cardiorenal syndrome.…”

Section: Discussionmentioning

confidence: 55%

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

et al. 2018

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Objective: Aortic arch calcification (AAC) is a surrogate marker for arterial stiffness and hypertension-related vascular damage. Renal resistive index (RRI), a renal Doppler ultrasonography parameter, is used to assess renal hemodynamics. In this study, we aimed to evaluate the relationship between RRI and AAC in patients with hypertension. Methods: Patients with hypertension underwent a chest X-ray and re nal Doppler ultrasonography. They were divided into two groups according to RRI (group 1: RRI ≥0.70; group 2: RRI < 0.70). Two examiners, blinded to the findings of RRI, reviewed the AAC in these patients. The kappa value was detected to be 0.781 and a p value < 0.001 was considered significant. Results: The study included 289 hypertensive patients (mean age 63.87 ± 11.38 years). In 53.6% (n = 155) of the study subjects, RRI was observed to be ≥0.70. Patients with RRI ≥70 were older and had more prevalent AAC as well as left ventricular hypertrophy. A multiple linear regression analysis was carried out to test whether presence of AAC significantly predicted RRI. The results of the regression analysis indicated that presence of AAC significantly predicted RRI (β = 0.053; p < 0.001). Conclusions: A strong and independent relationship was found between AAC on chest X-ray and RRI in patients with hypertension.

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Section: Discussionmentioning

confidence: 55%

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

et al. 2018

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“…IS and PCS induce deleterious effects in the endothelium, including the inhibition of cell proliferation and wound healing, and the increase in oxidative stress responses, cell senescence, and the release of endothelial microparticles [77][78][79][80]. A prospective observational study in 41 CKD patients revealed that AST-120 treatment decreased serum IS levels, as well as the oxidized/reduced glutathione ratio [79].…”

Section: The Endothelium An Overlooked Structure In the Process Of Umentioning

confidence: 99%

Molecular and Cellular Mechanisms that Induce Arterial Calcification by Indoxyl Sulfate and P-Cresyl Sulfate

Opdebeeck

D’Haese

Verhulst

2020

Toxins

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The protein-bound uremic toxins, indoxyl sulfate (IS) and p-cresyl sulfate (PCS), are considered to be harmful vascular toxins. Arterial media calcification, or the deposition of calcium phosphate crystals in the arteries, contributes significantly to cardiovascular complications, including left ventricular hypertrophy, hypertension, and impaired coronary perfusion in the elderly and patients with chronic kidney disease (CKD) and diabetes. Recently, we reported that both IS and PCS trigger moderate to severe calcification in the aorta and peripheral vessels of CKD rats. This review describes the molecular and cellular mechanisms by which these uremic toxins induce arterial media calcification. A complex interplay between inflammation, coagulation, and lipid metabolism pathways, influenced by epigenetic factors, is crucial in IS/PCS-induced arterial media calcification. High levels of glucose are linked to these events, suggesting that a good balance between glucose and lipid levels might be important. On the cellular level, effects on endothelial cells, which act as the primary sensors of circulating pathological triggers, might be as important as those on vascular smooth muscle cells. Endothelial dysfunction, provoked by IS and PCS triggered oxidative stress, may be considered a key event in the onset and development of arterial media calcification. In this review a number of important outstanding questions such as the role of miRNA’s, phenotypic switching of both endothelial and vascular smooth muscle cells and new types of programmed cell death in arterial media calcification related to protein-bound uremic toxins are put forward and discussed.

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“…P-cresol is a product of protein metabolism by gut bacteria; the administration of probiotics could decrease its production. 25 Some modified therapies have been more effective than conventional HD at removing certain PBUTs:…”

Section: Solute Removalmentioning

confidence: 99%

Dialysis membranes: A 2018 update

Olczyk¹,

Małyszczak²,

Kusztal³

2018

Polim. Med.

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Dialysis membranes are the basic element of a hemodialyzer. Synthetic and natural materials characterized by various fiber arrangements are used in their production. The most up-to-date ones are made of synthetic polymers such as polyamide, phosphatidylserine (PS), polyacrylonitrile-based fiber (PAN), polyarylethersulfone, polyethersulfone, or polymethylmethacrylate. Dialysis membranes are characterized by the ability to remove uremic molecules, which can be divided into small water-soluble compounds, protein-bound compounds and larger "middle molecules". Newer membranes such as medium cut off membranes (MCO) allow the removal of a wider spectrum of uremic molecules, which reduces the risk of late complications of dialysis. Dialysis membranes are used in therapy methods such as low flux, high flux or HDx therapy. An important aim in dialysis membrane development is to increase their biocompatibility. Insufficient biocompatibility can result in complement activation or platelet activation, which can lead to an increased risk of cardiovascular complications. The aim of the study is to discuss the latest reports on dialysis membranes.

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Vasculopathy in the setting of cardiorenal syndrome: roles of protein-bound uremic toxins

Cited by 34 publications

References 168 publications

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

Relationship between Aortic Arch Calcification, Detected by Chest X-Ray, and Renal Resistive Index in Patients with Hypertension

Molecular and Cellular Mechanisms that Induce Arterial Calcification by Indoxyl Sulfate and P-Cresyl Sulfate

Dialysis membranes: A 2018 update

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