Cardiotoxicity of Uremic Toxins: A Driver of Cardiorenal Syndrome.
Cardiotoxicity of Uremic Toxins: A Driver of Cardiorenal Syndrome.
复制标题
尿毒症毒素的心脏毒性：心脏综合征的驱动力。
DOI：
10.3390/toxins10090352
复制
发表时间：
2018-09-01
期刊：
影响因子：
4.2
通讯作者：
Lekawanvijit S
中科院分区：
文献类型：
--
作者：
Lekawanvijit S
心血管疾病(CVD)在慢性肾脏疾病(CKD)中非常普遍。CVD和CKD的这种共存--所谓的“心肾或肾心综合征”--导致心血管(CV)死亡的风险成倍增加。尿毒症心肌病是慢性肾脏病常见的一种特征性心脏病理改变。CKD患者也易发生心律失常，尤其是房颤。传统的心血管危险因素以及已知的慢性肾脏病相关心血管危险因素，如贫血，不足以解释慢性肾脏病人群中的心血管并发症。尿毒症滞留溶质积聚是肾脏排泄功能受损的标志。它们中的许多一直被认为是惰性的溶质，直到它们的生物毒性被揭开，它们被认为是“尿毒症毒素”。近年来，尿毒症毒素的直接心脏毒性越来越多地被证明。本文对尿毒症毒素引起的病理性心脏重构和功能障碍的机制进行了综述，主要集中在成纤维细胞生长因子-23，一种在慢性肾脏疾病-矿物性骨病中起核心作用的新出现的毒素，以及两种被研究最多的不可透析的蛋白结合的尿毒症毒素，吲哚硫酸盐和对甲酚硫酸盐。潜在的治疗策略，可以解决这些毒素及其相关的中介途径，自透析前阶段也进行了讨论。
Cardiovascular disease (CVD) is highly prevalent in the setting of chronic kidney disease (CKD). Such coexistence of CVD and CKD—the so-called “cardiorenal or renocardiac syndrome”—contributes to exponentially increased risk of cardiovascular (CV) mortality. Uremic cardiomyopathy is a characteristic cardiac pathology commonly found in CKD. CKD patients are also predisposed to heart rhythm disorders especially atrial fibrillation. Traditional CV risk factors as well as known CKD-associated CV risk factors such as anemia are insufficient to explain CV complications in the CKD population. Accumulation of uremic retention solutes is a hallmark of impaired renal excretory function. Many of them have been considered inert solutes until their biological toxicity is unraveled and they become accepted as “uremic toxins”. Direct cardiotoxicity of uremic toxins has been increasingly demonstrated in recent years. This review offers a mechanistic insight into the pathological cardiac remodeling and dysfunction contributed by uremic toxins with a main focus on fibroblastic growth factor-23, an emerging toxin playing a central role in the chronic kidney disease–mineral bone disorder, and the two most investigated non-dialyzable protein-bound uremic toxins, indoxyl sulfate and p-cresyl sulfate. Potential therapeutic strategies that could address these toxins and their relevant mediated pathways since pre-dialysis stages are also discussed.
登录
查看更多内容
影响因子：
6.1
作者：
Andersen, Ingrid A.;Huntley, Brenda K.;Burnett, John C., Jr.
通讯作者：
Burnett, John C., Jr.
影响因子：
19.6
作者：
Amann, K;Törnig, J;Ritz, E
通讯作者：
Ritz, E
DOI：
10.1006/bbrc.1998.9535
发表时间：
1998-10-29
影响因子：
3.1
作者：
Brown, JC;Rosenquist, TH;Monaghan, DT
通讯作者：
Monaghan, DT
影响因子：
13.2
作者：
Akizawa, Tadao;Asano, Yasushi;Kurokawa, Kiyoshi
通讯作者：
Kurokawa, Kiyoshi
影响因子：
3.2
作者：
AMANN, K;NEUSUSS, R;MALL, G
通讯作者：
MALL, G