4.6 Review

Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System

Journal

FRONTIERS IN PHYSIOLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fphys.2021.686249

Keywords

uremic toxins; cardiorenal syndrome; immune sustem; inflammation; cardiovascular diseases; renal diseases

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Funding

  1. Sao Paulo Research Foundation (FAPESP) [2018/03089-6, 2015/19107-5, 2019/11077-0]

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The accumulation of uremic toxins in the body can lead to a loss of various body functions, affecting other tissues and potentially causing cardiovascular issues. Understanding the impact of uremic toxins on the cardiovascular system is crucial for the treatment of patients with chronic kidney disease and high mortality rates among patients with cardiac comorbidities.
The kidneys and heart share functions with the common goal of maintaining homeostasis. When kidney injury occurs, many compounds, the so-called uremic retention solutes or uremic toxins, accumulate in the circulation targeting other tissues. The accumulation of uremic toxins such as p-cresyl sulfate, indoxyl sulfate and inorganic phosphate leads to a loss of a substantial number of body functions. Although the concept of uremic toxins is dated to the 1960s, the molecular mechanisms capable of leading to renal and cardiovascular injuries are not yet known. Besides, the greatest toxic effects appear to be induced by compounds that are difficult to remove by dialysis. Considering the close relationship between renal and cardiovascular functions, an understanding of the mechanisms involved in the production, clearance and overall impact of uremic toxins is extremely relevant for the understanding of pathologies of the cardiovascular system. Thus, the present study has as main focus to present an extensive review on the impact of uremic toxins in the cardiovascular system, bringing the state of the art on the subject as well as clinical implications related to patient's therapy affected by chronic kidney disease, which represents high mortality of patients with cardiac comorbidities.

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