Document Detail

Cardiorenal syndrome: the emerging role of protein-bound uremic toxins.
MedLine Citation:
PMID:  23139286     Owner:  NLM     Status:  MEDLINE    
Cardiorenal syndrome is a condition in which a complex interrelationship between cardiac dysfunction and renal dysfunction exists. Despite advances in treatment of both cardiovascular and kidney disease, cardiorenal syndrome remains a major global health problem. Characteristic of the pathophysiology of cardiorenal syndrome is bidirectional cross-talk; mediators/substances activated by the disease state of 1 organ can play a role in worsening dysfunction of the other by exerting their biologically harmful effects, leading to the progression of the syndrome. Accumulation of uremic toxins is a hallmark of renal excretory dysfunction. Removal of some toxins by conventional dialysis is particularly problematic because of their high protein binding. In this review, we demonstrate that protein-bound uremic toxins may play an important role in progression of cardiovascular disease in the setting of chronic kidney disease. The highly protein-bound uremic toxin indoxyl sulfate has emerged as a potent toxin adversely affecting both the kidney and heart. Direct cardiac effects of this toxin have been recently demonstrated both in vitro and in vivo. Specifically, potent fibrogenic and prohypertrophic effects, as well as oxidative stress-inducing effects, appear to play a central role in both renal and cardiac pathology. Many of these adverse effects can be suppressed by use of a gut adsorbent, AST-120. Potential mechanisms underlying indoxyl sulfate-induced cardiorenal fibrosis are discussed. Future research and clinical implications conclude this review.
Suree Lekawanvijit; Andrew R Kompa; Bing H Wang; Darren J Kelly; Henry Krum
Related Documents :
6495986 - Scleroderma of the colon presenting with acute abdominal symptoms.
18206446 - Congenital pouch colon syndrome in a saudi arabian neonate.
3654296 - Mesenteric and gastric volvulus in a dog.
22747926 - Witkop syndrome: a case report of an affected family.
1456416 - Delayed hypersensitivity to 6-methyl-prednisolone in henoch schöenlein syndrome.
24355046 - Fertility in patients with congenital adrenal hyperplasia.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Circulation research     Volume:  111     ISSN:  1524-4571     ISO Abbreviation:  Circ. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-09     Completed Date:  2013-02-05     Revised Date:  2014-03-02    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1470-83     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Carbon / therapeutic use
Cardio-Renal Syndrome / metabolism*,  prevention & control,  urine
Indican / metabolism,  urine
Oxidative Stress / drug effects
Oxides / therapeutic use
Protein Binding
Proteinuria / metabolism*,  urine
Toxins, Biological / metabolism*,  urine
Uremia / metabolism*,  urine
Reg. No./Substance:
0/Oxides; 0/Toxins, Biological; 7440-44-0/Carbon; 90597-58-3/AST 120; N187WK1Y1J/Indican
Erratum In:
Circ Res. 2014 Jan 17;114(2):e23

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  MicroRNAs micromanage themselves.
Next Document:  Genetic Cre-loxP assessment of epicardial cell fate using Wt1-driven Cre alleles.