Serum concentrations of indoxyl sulfate (the representative of uremic low molecular toxin bound to protein) and its possible influence: own observation and literature overview
Abstract
Indoxyl sulfate is an intensively studied uremic toxin. It is a small molecule that is derived from the amino acid tryptophan by action of intestinal bacteria, in the blood 90 % of indoxyl sulfate is bound to plasma proteins.
In physiological state, indoxyl sulfate is excreted from the body by the kidneys, however in the case of kidney damage indoxyl sulfate is retained in the body. Indoxyl sulfate as a retined substance affects the whole organism, it participates in the progression of immune dysfunction, cardiovascular damage, bone disorders, renal and cardiac fibrosis and others dysfunctions and complications associated with advanced renal disease and failure, with the most severe manifestation in patients in dialysis program.
Because the removal of indoxyl sulfate by dialysis techniques is very difficult and at best only partial, other ways to limit the high plasma concentration of indoxyl sulfate in patients with advanced renal disease, especially with chronic kidney disease, should be sought.