Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Food Science & Technology, Toxicology, uremic toxins, uremia, chronic kidney disease, cardiovascular disease, vascular smooth muscle cells, vascular calcification, middle molecules, protein bound uremic solutes, water-soluble uremic solutes, SMOOTH-MUSCLE-CELLS, CORONARY-ARTERY CALCIFICATION, CHRONIC KIDNEY-DISEASE, NF-KAPPA-B, NECROSIS-FACTOR-ALPHA, C-REACTIVE PROTEIN, SERUM URIC-ACID, PLASMA LEPTIN LEVELS, GLYCATION END-PRODUCT, INDOXYL SULFATE, Animals, Cardio-Renal Syndrome, Humans, Kidney, Muscle, Smooth, Vascular, Prognosis, Renal Insufficiency, Chronic, Toxins, Biological, Uremia, Vascular Calcification, 0601 Biochemistry and Cell Biology, 1115 Pharmacology and Pharmaceutical Sciences, 3214 Pharmacology and pharmaceutical sciences

Abstract:

The cardiorenal syndrome relates to the detrimental interplay between the vascular system and the kidney. The uremic milieu induced by reduced kidney function alters the phenotype of vascular smooth muscle cells (VSMC) and promotes vascular calcification, a condition which is strongly linked to cardiovascular morbidity and mortality. Biological mechanisms involved include generation of reactive oxygen species, inflammation and accelerated senescence. A better understanding of the vasotoxic effects of uremic retention molecules may reveal novel avenues to reduce vascular calcification in CKD. The present review aims to present a state of the art on the role of uremic toxins in pathogenesis of vascular calcification. Evidence, so far, is fragmentary and limited with only a few uremic toxins being investigated, often by a single group of investigators. Experimental heterogeneity furthermore hampers comparison. There is a clear need for a concerted action harmonizing and standardizing experimental protocols and combining efforts of basic and clinical researchers to solve the complex puzzle of uremic vascular calcification.