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Uremic Toxins and Vascular Calcification–Missing the Forest for All the Trees

1
Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6229 ER Maastricht, The Netherlands
2
Laboratory of Nephrology, KU Leuven Department of Microbiology and Immunology, University Hospitals Leuven, 3000 Leuven, Belgium
3
Karolinska Institute, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, 141 86 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(10), 624; https://doi.org/10.3390/toxins12100624
Received: 9 September 2020 / Revised: 22 September 2020 / Accepted: 25 September 2020 / Published: 29 September 2020
The cardiorenal syndrome relates to the detrimental interplay between the vascular system and the kidney. The uremic milieu induced by reduced kidney function alters the phenotype of vascular smooth muscle cells (VSMC) and promotes vascular calcification, a condition which is strongly linked to cardiovascular morbidity and mortality. Biological mechanisms involved include generation of reactive oxygen species, inflammation and accelerated senescence. A better understanding of the vasotoxic effects of uremic retention molecules may reveal novel avenues to reduce vascular calcification in CKD. The present review aims to present a state of the art on the role of uremic toxins in pathogenesis of vascular calcification. Evidence, so far, is fragmentary and limited with only a few uremic toxins being investigated, often by a single group of investigators. Experimental heterogeneity furthermore hampers comparison. There is a clear need for a concerted action harmonizing and standardizing experimental protocols and combining efforts of basic and clinical researchers to solve the complex puzzle of uremic vascular calcification. View Full-Text
Keywords: uremic toxins; uremia; chronic kidney disease; cardiovascular disease; vascular smooth muscle cells; vascular calcification; middle molecules; protein bound uremic solutes; water-soluble uremic solutes uremic toxins; uremia; chronic kidney disease; cardiovascular disease; vascular smooth muscle cells; vascular calcification; middle molecules; protein bound uremic solutes; water-soluble uremic solutes
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MDPI and ACS Style

Rapp, N.; Evenepoel, P.; Stenvinkel, P.; Schurgers, L. Uremic Toxins and Vascular Calcification–Missing the Forest for All the Trees. Toxins 2020, 12, 624.

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