Black Ana Paula, Cardozo Ludmila F M F, Mafra Denise
Graduate Program in Medical Sciences, Universidade Federal Fluminense (UFF), Niterói-RJ, Brazil.
Graduate Program in Cardiovascular Sciences, Universidade Federal Fluminense (UFF), Niterói-RJ, Brazil.
Ther Apher Dial. 2015 Oct;19(5):436-40. doi: 10.1111/1744-9987.12307. Epub 2015 May 5.
Patients with chronic kidney disease (CKD) frequently have mineral and bone disorders (CKD-MBD) that are caused by several mechanisms. Recent research has suggested that uremic toxins from the gut such as p-cresyl sulfate (PCS) and indoxyl sulfate (IS) could also be involved in the development of bone disease in patients with CKD. IS and PCS are produced by microbiota in the gut, carried into the plasma bound to serum albumin, and are normally excreted into the urine. However, in patients with CKD, there is an accumulation of high levels of these uremic toxins. The exact mechanisms of action of uremic toxins in bone disease remain unclear. The purpose of this brief review is to discuss the link between uremic toxins (IS and PCS) and bone mineral disease in chronic kidney disease.
慢性肾脏病（CKD）患者常出现由多种机制引起的矿物质和骨代谢紊乱（CKD-MBD）。最近的研究表明，肠道产生的尿毒症毒素，如对甲酚硫酸盐（PCS）和吲哚硫酸盐（IS），也可能参与CKD患者骨病的发生发展。IS和PCS由肠道微生物群产生，与血清白蛋白结合进入血浆，通常经尿液排出。然而，在CKD患者中，这些尿毒症毒素会大量蓄积。尿毒症毒素在骨病中的具体作用机制尚不清楚。本简要综述的目的是探讨尿毒症毒素（IS和PCS）与慢性肾脏病骨矿物质疾病之间的联系。
