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Toxins 2017, 9(1), 25; doi:10.3390/toxins9010025

Impact of Indoxyl Sulfate on Progenitor Cell-Related Neovascularization of Peripheral Arterial Disease and Post-Angioplasty Thrombosis of Dialysis Vascular Access

1
Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Hsinchu 30059, Taiwan
2
National Tsing-Hua University, Institute of Biomedical Engineering, Hsinchu 30013, Taiwan
3
School of Medicine, National Yang-Ming University, Taipei 11217, Taiwan
4
Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
5
Institutes of Physiology and Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan
6
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Raymond Vanholder
Received: 4 November 2016 / Revised: 28 December 2016 / Accepted: 4 January 2017 / Published: 7 January 2017
(This article belongs to the Special Issue Novel Issues in Uremic Toxicity)
View Full-Text   |   Download PDF [677 KB, uploaded 7 January 2017]   |  

Abstract

Patients with chronic kidney disease (CKD) have an increased risk of vascular disease, which is associated with considerable health care costs. Vascular disease in CKD differs clinically and pathobiologically from that in patients with normal renal function. Besides the traditional risk factors, retention of uremic toxins contributes to the pathogenesis of vascular disease in patients with CKD. Indoxyl sulfate is a protein-bound uremic toxin and is inefficiently removed by conventional dialysis. Accumulating evidence suggests that indoxyl sulfate is a vascular toxin involved in atherosclerosis, arteriosclerosis, vascular calcification and vascular repair. Clinically, indoxyl sulfate is associated with total and cardiovascular mortality in patients with CKD. Recent studies have indicated that in addition to coronary and cerebral arteries, indoxyl sulfate plays a role in peripheral artery disease (PAD) and dialysis graft thrombosis. Emerging evidence suggests that indoxyl sulfate is implicated via novel mechanisms, including progenitor cell-related neovascularization and tissue factor-related hypercoagulability. These findings raise the possibility that strategies targeting serum indoxyl sulfate may have the potential to improve the outcomes of PAD and dialysis vascular access in patients with CKD. View Full-Text
Keywords: chronic kidney disease; dialysis vascular access; indoxyl sulfate; peripheral artery disease; thrombosis; uremic toxin chronic kidney disease; dialysis vascular access; indoxyl sulfate; peripheral artery disease; thrombosis; uremic toxin
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Wu, C.-C.; Hung, S.-C.; Kuo, K.-L.; Tarng, D.-C. Impact of Indoxyl Sulfate on Progenitor Cell-Related Neovascularization of Peripheral Arterial Disease and Post-Angioplasty Thrombosis of Dialysis Vascular Access. Toxins 2017, 9, 25.

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