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尿毒症毒素:关乎心血管系统的一种惊人危险。

Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System.

作者信息

Falconi Carlos Alexandre, Junho Carolina Victoria da Cruz, Fogaça-Ruiz Fernanda, Vernier Imara Caridad Stable, da Cunha Regiane Stafim, Stinghen Andréa Emilia Marques, Carneiro-Ramos Marcela Sorelli

机构信息

Laboratory of Cardiovascular Immunology, Center of Natural and Human Sciences (CCNH), Federal University of ABC, Santo André, Brazil.

Experimental Nephrology Laboratory, Basic Pathology Department, Universidade Federal do Paraná, Curitiba, Brazil.

出版信息

Front Physiol. 2021 May 14;12:686249. doi: 10.3389/fphys.2021.686249. eCollection 2021.

Abstract

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 -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 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.

摘要

肾脏和心脏具有共同维持内环境稳定的功能。当肾脏发生损伤时,许多化合物,即所谓的“尿毒症潴留溶质”或“尿毒症毒素”,会在循环中蓄积并靶向其他组织。硫酸对甲酚、硫酸吲哚酚和无机磷酸盐等尿毒症毒素的蓄积会导致大量身体功能丧失。尽管尿毒症毒素的概念可追溯到20世纪60年代,但导致肾脏和心血管损伤的分子机制尚不清楚。此外,最大的毒性作用似乎是由难以通过透析清除的化合物引起的。考虑到肾脏和心血管功能之间的密切关系,了解尿毒症毒素的产生、清除及其总体影响所涉及的机制对于理解心血管系统疾病极为重要。因此,本研究的主要重点是对尿毒症毒素在心血管系统中的影响进行广泛综述,介绍该主题的最新进展以及与受慢性肾脏病影响的患者治疗相关的临床意义,慢性肾脏病在合并心脏疾病的患者中具有很高的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c08a/8160254/7789c200d439/fphys-12-686249-g001.jpg

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