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Food-Derived Uremic Toxins in Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have a higher cardiovascular risk compared to the average population, and this is partially due to the plasma accumulation of solutes known as uremic toxins. The binding of some solutes to plasma proteins complicates their removal via conventional therapies...

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Autores principales: Lauriola, Mara, Farré, Ricard, Evenepoel, Pieter, Overbeek, Saskia Adriana, Meijers, Björn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960799/
https://www.ncbi.nlm.nih.gov/pubmed/36828430
http://dx.doi.org/10.3390/toxins15020116
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author Lauriola, Mara
Farré, Ricard
Evenepoel, Pieter
Overbeek, Saskia Adriana
Meijers, Björn
author_facet Lauriola, Mara
Farré, Ricard
Evenepoel, Pieter
Overbeek, Saskia Adriana
Meijers, Björn
author_sort Lauriola, Mara
collection PubMed
description Patients with chronic kidney disease (CKD) have a higher cardiovascular risk compared to the average population, and this is partially due to the plasma accumulation of solutes known as uremic toxins. The binding of some solutes to plasma proteins complicates their removal via conventional therapies, e.g., hemodialysis. Protein-bound uremic toxins originate either from endogenous production, diet, microbial metabolism, or the environment. Although the impact of diet on uremic toxicity in CKD is difficult to quantify, nutrient intake plays an important role. Indeed, most uremic toxins are gut-derived compounds. They include Maillard reaction products, hippurates, indoles, phenols, and polyamines, among others. In this review, we summarize the findings concerning foods and dietary components as sources of uremic toxins or their precursors. We then discuss their endogenous metabolism via human enzyme reactions or gut microbial fermentation. Lastly, we present potential dietary strategies found to be efficacious or promising in lowering uremic toxins plasma levels. Aligned with current nutritional guidelines for CKD, a low-protein diet with increased fiber consumption and limited processed foods seems to be an effective treatment against uremic toxins accumulation.
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spelling pubmed-99607992023-02-26 Food-Derived Uremic Toxins in Chronic Kidney Disease Lauriola, Mara Farré, Ricard Evenepoel, Pieter Overbeek, Saskia Adriana Meijers, Björn Toxins (Basel) Review Patients with chronic kidney disease (CKD) have a higher cardiovascular risk compared to the average population, and this is partially due to the plasma accumulation of solutes known as uremic toxins. The binding of some solutes to plasma proteins complicates their removal via conventional therapies, e.g., hemodialysis. Protein-bound uremic toxins originate either from endogenous production, diet, microbial metabolism, or the environment. Although the impact of diet on uremic toxicity in CKD is difficult to quantify, nutrient intake plays an important role. Indeed, most uremic toxins are gut-derived compounds. They include Maillard reaction products, hippurates, indoles, phenols, and polyamines, among others. In this review, we summarize the findings concerning foods and dietary components as sources of uremic toxins or their precursors. We then discuss their endogenous metabolism via human enzyme reactions or gut microbial fermentation. Lastly, we present potential dietary strategies found to be efficacious or promising in lowering uremic toxins plasma levels. Aligned with current nutritional guidelines for CKD, a low-protein diet with increased fiber consumption and limited processed foods seems to be an effective treatment against uremic toxins accumulation. MDPI 2023-02-01 /pmc/articles/PMC9960799/ /pubmed/36828430 http://dx.doi.org/10.3390/toxins15020116 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Lauriola, Mara
Farré, Ricard
Evenepoel, Pieter
Overbeek, Saskia Adriana
Meijers, Björn
Food-Derived Uremic Toxins in Chronic Kidney Disease
title Food-Derived Uremic Toxins in Chronic Kidney Disease
title_full Food-Derived Uremic Toxins in Chronic Kidney Disease
title_fullStr Food-Derived Uremic Toxins in Chronic Kidney Disease
title_full_unstemmed Food-Derived Uremic Toxins in Chronic Kidney Disease
title_short Food-Derived Uremic Toxins in Chronic Kidney Disease
title_sort food-derived uremic toxins in chronic kidney disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960799/
https://www.ncbi.nlm.nih.gov/pubmed/36828430
http://dx.doi.org/10.3390/toxins15020116
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