Uremic Toxins and Vascular Dysfunction

Toxins (Basel). 2020 Jun 18;12(6):404. doi: 10.3390/toxins12060404.

Abstract

Vascular dysfunction is an essential element found in many cardiovascular pathologies and in pathologies that have a cardiovascular impact such as chronic kidney disease (CKD). Alteration of vasomotricity is due to an imbalance between the production of relaxing and contracting factors. In addition to becoming a determining factor in pathophysiological alterations, vascular dysfunction constitutes the first step in the development of atherosclerosis plaques or vascular calcifications. In patients with CKD, alteration of vasomotricity tends to emerge as being a new, less conventional, risk factor. CKD is characterized by the accumulation of uremic toxins (UTs) such as phosphate, para-cresyl sulfate, indoxyl sulfate, and FGF23 and, consequently, the deleterious role of UTs on vascular dysfunction has been explored. This accumulation of UTs is associated with systemic alterations including inflammation, oxidative stress, and the decrease of nitric oxide production. The present review proposes to summarize our current knowledge of the mechanisms by which UTs induce vascular dysfunction.

Keywords: chronic kidney disease; uremic toxins; vascular dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Blood Vessels / metabolism*
  • Blood Vessels / physiopathology
  • Cresols / blood*
  • Fibroblast Growth Factor-23
  • Humans
  • Indican / blood*
  • Inflammation Mediators / metabolism
  • Oxidative Stress
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / therapy
  • Sulfuric Acid Esters / blood*
  • Uremia / blood
  • Uremia / complications*
  • Uremia / physiopathology
  • Uremia / therapy
  • Vascular Diseases / blood
  • Vascular Diseases / etiology*
  • Vascular Diseases / physiopathology
  • Vascular Diseases / prevention & control

Substances

  • Cresols
  • FGF23 protein, human
  • Inflammation Mediators
  • Sulfuric Acid Esters
  • 4-cresol sulfate
  • Fibroblast Growth Factor-23
  • Indican