Uremic toxins protein bound

Keywords Uremic toxins Protein bound toxins... 

Sarnatskaya V, Yushko L, Nikolaev A et al (2007) New approaches to the removal of protein-bound toxins from blood plasma of uremic patients. Artif Cells Blood Substit ImmobU Biotechnol 3 287-308... 

The results of microcolumn experiments presented in Fig. 29.9 prove that perfusion through HSGD purifies HSA from a mixture of uremic toxins, which have high, medium and low affinity with albumin (Table 29.1) [11]. The results show that even after 4 h of perfusion the concentration of all three protein-bound uremic toxins remains low, and their clearance is respectively high [10]. 

Garcia, A. Heinanen, M. Jimenez, L.M. Barbas, C. Direct measurement of homovaniUic, vaniUylmandehc and 5-hydroxyindole acetic acids in urine by capillary electrophoresis. J. Chromatogr., A 2000, 871, 341-350. Vanholder, R. de Smet, R. Lameire, N. Protein bound uremic solutes The forgotten toxins. Kidney Inter., Suppl. 2001, 78, S266-S270. 

Vanholder R, De Smet R Lameiie N. (2001). Protein-bound uremic solutes The forgotten toxins. Kidney int 59 (Suppl. 78), S266-S270. 

Cresol and hippuric acid are included among uremic toxins. p-Cresol (4-methylphenol) is a volatile, low-molecular-weight phenolic compound that is largely protein-bound, mainly to albumin, with partial lipophilic properties. It is related to several biochemical, biological, and physiological functions at concentrations currently observed in uremia. 

Further complications may arise in that uremic toxicity depends on individual patient characteristics [72] and an increased capacity of the albumin molecule to bind toxins in the uremic state [73, 74], that leads to the accumulation of protein-bound uremic toxins. Consequently, either protein-permeable membranes will play a major role in the future or adsorber systems should be implemented in addition. 

Protein-Bound Uremic Toxins Among the 20 protein-bound uremic toxins identified in the EUTox review (Vanholder et al., 2003), leptin and retinol binding protein were middle molecules, and 18 others were small solutes (MW < 500 Da). Some of these protein-bound molecules exert a toxic effect at concentrations observed in dialysis patients. For example, the 3-carboxy-4-methyl propylfuranpropionic acid, which is 98% bound to albumin, inhibits erythropoiesis (Niwa et al., 1990). Similarly, P-cresol and indoxyl sulfate, both of which are nearly 100% protein bound, inhibit endothelial... 

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