The Role of Gut-Derived, Protein-Bound Uremic Toxins in the Cardiovascular Complications of Acute Kidney Injury

Toxins (Basel). 2022 May 11;14(5):336. doi: 10.3390/toxins14050336.

Abstract

Acute kidney injury (AKI) is a frequent disease encountered in the hospital, with a higher incidence in intensive care units. Despite progress in renal replacement therapy, AKI is still associated with early and late complications, especially cardiovascular events and mortality. The role of gut-derived protein-bound uremic toxins (PBUTs) in vascular and cardiac dysfunction has been extensively studied during chronic kidney disease (CKD), in particular, that of indoxyl sulfate (IS), para-cresyl sulfate (PCS), and indole-3-acetic acid (IAA), resulting in both experimental and clinical evidence. PBUTs, which accumulate when the excretory function of the kidneys is impaired, have a deleterious effect on and cause damage to cardiovascular tissues. However, the link between PBUTs and the cardiovascular complications of AKI and the pathophysiological mechanisms potentially involved are unclear. This review aims to summarize available data concerning the participation of PBUTs in the early and late cardiovascular complications of AKI.

Keywords: acute kidney injury; cardiovascular dysfunction; indole-3-acetic acid; indoxyl sulfate; para-cresyl sulfate; uremic toxins.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / etiology
  • Heart Diseases*
  • Humans
  • Kidney
  • Renal Insufficiency, Chronic* / complications
  • Uremic Toxins

Substances

  • Uremic Toxins

Grants and funding

This research received no external funding.