3,822 results match your criteria uremic toxins

The Kidney-Heart Connection in Obesity.

Nephron 2021 Apr 13:1-5. Epub 2021 Apr 13.

Área de Bioquímica y Biología Molecular, Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.

There is a strong relationship between the kidney and the heart, where if one of these organs fails, so does the other, in the so-called cardiorenal syndrome (CRS). Besides, there are also interactions with the rest of the body leading to a metabolic state that establishes a feedback loop that is perpetuated. The CRS is characterized by hemodynamic changes, activation of neuro-humoral systems, natriuretic peptides, and changes in mineral metabolism. Read More

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Serum total indoxyl sulfate and clinical outcomes in hemodialysis patients: results from the Japan Dialysis Outcomes and Practice Patterns Study.

Clin Kidney J 2021 Apr 31;14(4):1236-1243. Epub 2020 Jul 31.

Division of Nephrology, Endocrinology and Metabolism, Tokai University School of Medicine, Isehara, Japan.

Background: Uremic toxins are associated with various chronic kidney disease-related comorbidities. Indoxyl sulfate (IS), a protein-bound uremic toxin, reacts with vasculature, accelerating atherosclerosis and/or vascular calcification in animal models. Few studies have examined the relationship of IS with clinical outcomes in a large cohort of hemodialysis (HD) patients. Read More

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The long-term genetic stability and individual specificity of the human gut microbiome.

Cell 2021 Apr 4. Epub 2021 Apr 4.

Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands; Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen 9713GZ, the Netherlands. Electronic address:

By following up the gut microbiome, 51 human phenotypes and plasma levels of 1,183 metabolites in 338 individuals after 4 years, we characterize microbial stability and variation in relation to host physiology. Using these individual-specific and temporally stable microbial profiles, including bacterial SNPs and structural variations, we develop a microbial fingerprinting method that shows up to 85% accuracy in classifying metagenomic samples taken 4 years apart. Application of our fingerprinting method to the independent HMP cohort results in 95% accuracy for samples taken 1 year apart. Read More

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Reconsidering adsorption in hemodialysis: is it just an epiphenomenon? A narrative review.

J Nephrol 2021 Apr 10. Epub 2021 Apr 10.

Department of Nephrology, Dialysis and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 Place d'Arsonval, Cedex 03, 6943769003, Lyon, France.

Since the first attempt at extracorporeal renal replacement therapy, renal replacement therapy has been constantly improved. In the field of hemodialysis, substantial efforts have been made to improve toxin removal and biocompatibility. The advent of hemodiafiltration (HDF) and, more recently, of mid cut-off membranes have contributed to management of patients with end-stage renal disease (ESRD). Read More

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Disruptive technologies for hemodialysis: medium and high cutoff membranes. Is the future now?

J Bras Nefrol 2021 Apr 9. Epub 2021 Apr 9.

San Bortolo Hospital, International Renal Research Institute of Vicenza, Department of Nephrology, Dialysis and Transplantation, Vicenza, Italy.

In the past decade, a new class of hemodialysis (HD) membranes (high retention onset class) became available for clinical use. The high cutoff (HCO) and the medium cutoff (MCO) membranes have wider pores and more uniformity in pore size, allowing an increased clearance of uremic toxins. Owing to the mechanism of backfiltration/internal filtration, middle molecules are dragged by the convective forces, and no substitution solution is needed. Read More

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Microbiota, renal disease and renal transplantation.

World J Transplant 2021 Mar;11(3):16-36

Nephrology and Dialysis Unit, Saints Cosmas and Damian Hospital, Pescia 51017, Italy.

Aim of this frontier review has been to highlight the role of microbiota in healthy subjects and in patients affected by renal diseases with particular reference to renal transplantation. The microbiota has a relevant role in conditioning the healthy status and the diseases. In particular gut microbiota is essential in the metabolism of food and has a relevant role for its relationship with the immune system. Read More

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Uremic Toxins and Blood Purification: A Review of Current Evidence and Future Perspectives.

Toxins (Basel) 2021 Mar 30;13(4). Epub 2021 Mar 30.

Aferetica S.r.l, Via Spartaco 10, 40138 Bologna (BO), Italy.

Accumulation of uremic toxins represents one of the major contributors to the rapid progression of chronic kidney disease (CKD), especially in patients with end-stage renal disease that are undergoing dialysis treatment. In particular, protein-bound uremic toxins (PBUTs) seem to have an important key pathophysiologic role in CKD, inducing various cardiovascular complications. The removal of uremic toxins from the blood with dialytic techniques represents a proved approach to limit the CKD-related complications. Read More

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Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate.

Toxins (Basel) 2021 Mar 31;13(4). Epub 2021 Mar 31.

Department of Health Technologies, Tallinn University of Technology, 19086 Tallinn, Estonia.

Optical monitoring of spent dialysate has been used to estimate the removal of water-soluble low molecular weight as well as protein-bound uremic toxins from the blood of end stage kidney disease (ESKD) patients. The aim of this work was to develop an optical method to estimate the removal of β2-microglobulin (β2M), a marker of middle molecule (MM) uremic toxins, during hemodialysis (HD) treatment. Ultraviolet (UV) and fluorescence spectra of dialysate samples were recorded from 88 dialysis sessions of 22 ESKD patients, receiving four different settings of dialysis treatments. Read More

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The Impact of CKD on Uremic Toxins and Gut Microbiota.

Toxins (Basel) 2021 Mar 31;13(4). Epub 2021 Mar 31.

Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland.

Numerous studies have indicated that the progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD) is strictly associated with the accumulation of toxic metabolites in blood and other metabolic compartments. This accumulation was suggested to be related to enhanced generation of toxins from the dysbiotic microbiome accompanied by their reduced elimination by impaired kidneys. Intestinal microbiota play a key role in the accumulation of uremic toxins due to the fact that numerous uremic solutes are generated in the process of protein fermentation by colonic microbiota. Read More

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Medium Cut-Off Dialysis Membrane and Dietary Fiber Effects on Inflammation and Protein-Bound Uremic Toxins: A Systematic Review and Protocol for an Interventional Study.

Toxins (Basel) 2021 Mar 29;13(4). Epub 2021 Mar 29.

Department of Nephrology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.

The aim of this systematic review is to investigate the effects of the use of a medium cut-off membrane (MCO) and dietary fiber on the concentration of protein-bound uremic toxins (PBUTs) and inflammatory markers in hemodialysis (HD) patients. Of 11,397 papers originally found, eight met the criteria of randomized controlled trial design. No study examined the effects of MCO membranes on PBUTs. Read More

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Thrombolome and Its Emerging Role in Chronic Kidney Diseases.

Toxins (Basel) 2021 Mar 18;13(3). Epub 2021 Mar 18.

1st Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, Zurawia 14 St., 15-450 Bialystok, Poland.

Patients with chronic kidney disease (CKD) are at an increased risk of thromboembolic complications, including myocardial infarction, stroke, deep vein thrombosis, and pulmonary embolism. These complications lead to increased mortality. Evidence points to the key role of CKD-associated dysbiosis and its effect via the generation of gut microbial metabolites in inducing the prothrombotic phenotype. Read More

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Shiga Toxins: An Update on Host Factors and Biomedical Applications.

Toxins (Basel) 2021 Mar 18;13(3). Epub 2021 Mar 18.

Department of Urology, Boston Children's Hospital, Boston, MA 02115, USA.

Shiga toxins (Stxs) are classic bacterial toxins and major virulence factors of toxigenic and enterohemorrhagic (EHEC). These toxins recognize a glycosphingolipid globotriaosylceramide (Gb3/CD77) as their receptor and inhibit protein synthesis in cells by cleaving 28S ribosomal RNA. They are the major cause of life-threatening complications such as hemolytic uremic syndrome (HUS), associated with severe cases of EHEC infection, which is the leading cause of acute kidney injury in children. Read More

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[Development of Novel Methodology and Its Application for Clarifying the Transport Function of the Blood-brain Barrier].

Tetsuya Terasaki

Yakugaku Zasshi 2021 ;141(4):447-462

Membrane Transport and Drug Targeing Laboratory, Graduate School of Pharmaceutical Sciences, Tohoku University.

The blood-brain barrier (BBB) consists of brain capillary endothelial cells linked by tight junctions and serves to regulate the transfer of endogenous compounds and xenobiotics between the circulating blood and brain interstitial fluid. We have developed a methodology to characterize brain-to-blood efflux transport in vivo, using the Brain Efflux Index and an in vitro culture model of the BBB, i.e. Read More

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January 2021

Potential interactions between uremic toxins and drugs: an application in kidney transplant recipients treated with calcineurin inhibitors.

Nephrol Dial Transplant 2021 Mar 30. Epub 2021 Mar 30.

MP3CV Laboratory, EA7517, Jules Verne University of Picardie, Amiens, F-80000 Amiens, France.

Background: The uremic toxins that accumulate with as renal function deteriorates can potentially affect drug pharmacokinetics. The study's objective was to determine whether plasma concentrations of certain uremic toxins were correlated with blood concentrations of two immunosuppressants.

Methods: DRUGTOX was a cross-sectional study of 403 adult patients followed up after kidney transplantation and who had undergone therapeutic drug monitoring (TDM) of calcineurin inhibitors (tacrolimus or cyclosporin) between August 2019, and March 2020. Read More

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Effect of a medium cut-off dialyzer on protein-bound uremic toxins and mineral metabolism markers in patients on hemodialysis.

Hemodial Int 2021 Mar 28. Epub 2021 Mar 28.

Department of Nephrology, The Royal Melbourne Hospital, Parkville, Australia.

Introduction: Hemodialysis (HD) with medium cut-off (MCO) dialyzers may expand molecular clearance, predominantly larger middle molecules (molecular weight 25-60 kDa). However, the impact of MCO dialyzers on long-term clearance of various other components of the uremic milieu is unknown. The tRial Evaluating Mid cut-Off Value membrane clearance of Albumin and Light chains in HemoDialysis patients (REMOVAL-HD) provided an opportunity to assess the effect of MCO dialyzers on protein-bound uremic toxins and novel markers of mineral metabolism. Read More

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New insights into muscle function in chronic kidney disease and metabolic acidosis.

Curr Opin Nephrol Hypertens 2021 May;30(3):369-376

Division of Nephrology, Department of Medicine, University of California Davis, Sacramento, California.

Purpose Of Review: : Sarcopenia, defined as decreased muscle mass or function, is prevalent in chronic kidney disease (CKD) increasing the risk of mobility impairment and frailty. CKD leads to metabolic acidosis (MA) and retention of uremic toxins contributing to insulin resistance and impaired muscle mitochondrial energetics. Here we focus on the central role of muscle mitochondrial metabolism in muscle function. Read More

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Uraemic solutes as therapeutic targets in CKD-associated cardiovascular disease.

Nat Rev Nephrol 2021 Mar 23. Epub 2021 Mar 23.

Renal Section, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.

Chronic kidney disease (CKD) is characterized by the retention of a myriad of solutes termed uraemic (or uremic) toxins, which inflict damage to several organs, including the cardiovascular system. Uraemic toxins can induce hallmarks of cardiovascular disease (CVD), such as atherothrombosis, heart failure, dysrhythmias, vessel calcification and dysregulated angiogenesis. CVD is an important driver of mortality in patients with CKD; however, reliance on conventional approaches to managing CVD risk is insufficient in these patients, underscoring a need to target risk factors that are specific to CKD. Read More

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Renal and non-renal response of ABC and SLC transporters in chronic kidney disease.

Expert Opin Drug Metab Toxicol 2021 Mar 22. Epub 2021 Mar 22.

Departments of Pediatrics and Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093-0693, USA.

Introduction: The solute carrier (SLC) and the ATP-binding cassette (ABC) transporter superfamilies play essential roles in the disposition of small molecules (endogenous metabolites, uremic toxins, drugs) in the blood, kidney, liver, intestine, and other organs. In chronic kidney disease (CKD), the loss of renal function is associated with altered function of remote organs. As renal function declines, many molecules-including protein-bound uremic toxins and cytokines-accumulate in the plasma. Read More

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The Role of Dietary Fiber Supplementation in Regulating Uremic Toxins in Patients With Chronic Kidney Disease: A Meta-Analysis of Randomized Controlled Trials.

J Ren Nutr 2021 Mar 16. Epub 2021 Mar 16.

Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China. Electronic address:

Objectives: The results of previously published meta-analyses showed that dietary fiber could reduce the levels of p-cresyl sulfate, blood urea nitrogen, and creatinine in patients with chronic kidney disease (CKD). However, these results were based on some trials with pre-post design and randomized controlled trials of low quality. Additionally, it has been suggested that the dosage and duration of fiber supplementation and patients' characteristics potentially influence the effect of dietary fiber in reducing uremic toxins, but it would appear that no research has provided reliable evidence. Read More

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Analyzing the Long Time-Scale Dynamics of Uremic Toxins Bound to Sudlow Site II in Human Serum Albumin.

J Phys Chem B 2021 03 15;125(11):2910-2920. Epub 2021 Mar 15.

Department of Chemistry, University of Washington, Seattle, Washington 98195-1700, United States.

Protein bound uremic toxins (PBUTs), a series of chemicals that remain a challenge for removal strategies used on patients suffering with chronic kidney disease, could be strong candidates for MD study in order to better understand the interactions and time scales associated with binding mode transitions. Currently, traditional dialysis methods cannot satisfactorily remove PBUTs from the bloodstream. This is at least partly due to these toxin's high level of affinity for protein binding sites, particularly the prominent human serum albumin (HSA) and two of its drug binding sites (Sudlow site I and II). Read More

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Citrobacter rodentium Lysogenized with a Shiga Toxin-Producing Phage: A Murine Model for Shiga Toxin-Producing E. coli Infection.

Methods Mol Biol 2021 ;2291:381-397

Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA.

Shiga toxin-producing E. coli (STEC) is a common foodborne pathogen in developed countries. STEC generates "attaching and effacing" (AE) lesions on colonic epithelium, characterized by effacement of microvilli and the formation of actin "pedestals" beneath intimately attached bacteria. Read More

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Molecular Detection of a New Pathotype Enteroaggregative Haemorrhagic (EAHEC) in Indonesia, 2015.

Infect Dis Rep 2020 Jul 7;12(11):98-100. Epub 2020 Jul 7.

Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan.

Enteroaggregative haemorrhagic ( EAHEC) has been identified as the agent responsible for one of the largest outbreaks of gastroenteritis and Haemolytic-uremic syndrome (HUS) that is transmitted through food in Germany in 2011. The hypervirulent pathotype has a unique combination of two pathogens namely enterohemorrhagic strain (EHEC) which produces shiga/verotoxin and enteroaggregative toxins (EAEC) which produces toxins similar to ST and hemolysin. The toxin produced by the EAHEC strain is a hybrid pathotype that combines the virulence potential of the EAEC and EHEC strains that will damage the microcirculation, cause vasculitis and other toxic effects. Read More

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Potential Effects of Immunosuppression on Oxidative Stress and Atherosclerosis in Kidney Transplant Recipients.

Oxid Med Cell Longev 2021 20;2021:6660846. Epub 2021 Feb 20.

Department of Nephrology, Dialysis & Internal Diseases, The Medical University of Warsaw, Poland.

Chronic kidney disease is a public health problem that, depending on the country, affects approximately 8-13% of the population, involving both males and females of all ages. Renal replacement therapy remains one of the most costly procedures. It is assumed that one of the factors influencing the course of chronic kidney disease might be oxidative stress. Read More

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February 2021

The conserved regulator of autophagy and innate immunity hlh-30/TFEB mediates tolerance of enterohemorrhagic Escherichia coli in Caenorhabditis elegans.

Genetics 2021 Mar;217(1):1-17

Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.

Infection with antibiotic-resistant bacteria is an emerging life-threatening issue worldwide. Enterohemorrhagic Escherichia coli O157: H7 (EHEC) causes hemorrhagic colitis and hemolytic uremic syndrome via contaminated food. Treatment of EHEC infection with antibiotics is contraindicated because of the risk of worsening the syndrome through the secreted toxins. Read More

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Shiga Toxin (Stx)-Binding Glycosphingolipids of Primary Human Renal Cortical Epithelial Cells (pHRCEpiCs) and Stx-Mediated Cytotoxicity.

Toxins (Basel) 2021 Feb 12;13(2). Epub 2021 Feb 12.

Institute of Hygiene, University of Münster, D-48149 Münster, Germany.

Human kidney epithelial cells are supposed to be directly involved in the pathogenesis of the hemolytic-uremic syndrome (HUS) caused by Shiga toxin (Stx)-producing enterohemorrhagic (EHEC). The characterization of the major and minor Stx-binding glycosphingolipids (GSLs) globotriaosylceramide (Gb3Cer) and globotetraosylceramide (Gb4Cer), respectively, of primary human renal cortical epithelial cells (pHRCEpiCs) revealed GSLs with Cer (d18:1, C16:0), Cer (d18:1, C22:0), and Cer (d18:1, C24:1/C24:0) as the dominant lipoforms. Using detergent-resistant membranes (DRMs) and non-DRMs, Gb3Cer and Gb4Cer prevailed in the DRM fractions, suggesting their association with microdomains in the liquid-ordered membrane phase. Read More

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February 2021

Effect of Unripe Banana Flour on Gut-Derived Uremic Toxins in Individuals Undergoing Peritoneal Dialysis: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial.

Nutrients 2021 Feb 17;13(2). Epub 2021 Feb 17.

Nutrition Program, Universidade Federal de São Paulo-UNIFESP, São Paulo 05508-000, Brazil.

In chronic kidney disease (CKD), the accumulation of gut-derived metabolites, such as indoxyl sulfate (IS), p-cresyl sulfate (pCS), and indole 3-acetic acid (IAA), has been associated with the burden of the disease. In this context, prebiotics emerge as a strategy to mitigate the accumulation of such compounds, by modulating the gut microbiota and production of their metabolites. The aim of this study was to evaluate the effect of unripe banana flour (UBF-48% resistant starch, a prebiotic) on serum concentrations of IS, pCS, and IAA in individuals undergoing peritoneal dialysis (PD). Read More

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February 2021

Ketoanalogs' Effects on Intestinal Microbiota Modulation and Uremic Toxins Serum Levels in Chronic Kidney Disease (Medika2 Study).

J Clin Med 2021 Feb 18;10(4). Epub 2021 Feb 18.

Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, "AldoMoro" University, 70124 Bari, Italy.

Nutritional therapy (NT) is a therapeutic option in the conservative treatment of chronic kidney disease (CKD) patients to delay the start of dialysis. The aim of this study was to evaluate the specific effect of ketoanalogs (KA)-supplemented diets for gut microbiota modulation. In a previous study we observed that the Mediterranean diet (MD) and a KA-supplemented very-low-protein diet (VLPD) modulated beneficially gut microbiota, reducing indoxyl- and p-cresyl-sulfate (IS, PCS) serum levels, and ameliorating the intestinal permeability in CKD patients. Read More

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February 2021

Uremic Toxins in the Progression of Chronic Kidney Disease and Cardiovascular Disease: Mechanisms and Therapeutic Targets.

Toxins (Basel) 2021 Feb 13;13(2). Epub 2021 Feb 13.

Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 3K7, Canada.

Chronic kidney disease (CKD) is a progressive loss of renal function. The gradual decline in kidney function leads to an accumulation of toxins normally cleared by the kidneys, resulting in uremia. Uremic toxins are classified into three categories: free water-soluble low-molecular-weight solutes, protein-bound solutes, and middle molecules. Read More

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February 2021

Inverted U-Curve Association between Serum Indoxyl Sulfate Levels and Cardiovascular Events in Patients on Chronic Hemodialysis.

J Clin Med 2021 Feb 13;10(4). Epub 2021 Feb 13.

Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan.

Background: Protein-bound uremic toxins are associated with cardiovascular disease and mortality in patients with chronic kidney disease. We investigated their association with clinical outcomes in patients undergoing chronic hemodialysis (CHD).

Methods: A prospective cohort study was conducted on 86 Taiwanese patients undergoing CHD. Read More

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February 2021

Effect of uremic toxins on hippocampal cell damage: analysis in vitro and in rat model of chronic kidney disease.

Heliyon 2021 Feb 10;7(2):e06221. Epub 2021 Feb 10.

Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan.

One third of the patients with chronic kidney disease (CKD) develop cognitive impairment, which is also an independent risk factor for mortality. However, the concise mechanism of cerebro-renal interaction has not been clarified. The present study examines the effects of uremic toxins on neuronal cells and analyzes the pathological condition of the brain using mouse hippocampal neuronal HT-22 cells and adenine-induced CKD model rats. Read More

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February 2021