New Strategies for the Reduction of Uremic Toxins (2022)

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Uremic Toxins".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 14773

Special Issue Editor


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Guest Editor
Applied Biology - Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
Interests: biomarkers of CKD; uremic toxins; microbiota; probiotics; proteomics
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Special Issue Information

Dear Colleagues,

Following on from the first Special Issue on the topic, “New Strategies for the Reduction of Uremic Toxins (2022)" will focus on uremia and uremic toxins, especially those deriving from intestinal microbiota, on their multi-organ influence and triggering of various diseases. Indeed, high levels of uremic toxins are associated with chronic kidney disease, heart disease, obesity, non-alcoholic fatty acid disease, rheumatoid arthritis and depression, cancer, diabetes, and inflammatory bowel disease. Therefore, contributions and experiences deriving from different medical specialties will be welcome and very useful to better define the role of uremic toxins and the best methods or strategies to manage them at systemic levels.

Dr. Maria Teresa Rocchetti
Guest Editor

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Keywords

  • uremic toxins
  • indoxyl sulfate
  • p-cresyl sulfate
  • microbiota
  • probiotics

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Related Special Issue

Published Papers (5 papers)

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Research

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14 pages, 4033 KiB  
Article
Improving the In Vitro Removal of Indoxyl Sulfate and p-Cresyl Sulfate by Coating Diatomaceous Earth (DE) and Poly-vinyl-pyrrolidone-co-styrene (PVP-co-S) with Polydopamine
by Stefania Roberta Cicco, Maria Michela Giangregorio, Maria Teresa Rocchetti, Ighli di Bari, Claudio Mastropaolo, Rossella Labarile, Roberta Ragni, Loreto Gesualdo, Gianluca Maria Farinola and Danilo Vona
Toxins 2022, 14(12), 864; https://doi.org/10.3390/toxins14120864 - 8 Dec 2022
Cited by 4 | Viewed by 2184
Abstract
Polydopamine (PDA) is a synthetic eumelanin polymer mimicking the biopolymer secreted by mussels to attach to surfaces with a high binding strength. It exhibits unique adhesive properties and has recently attracted considerable interest as a multifunctional thin film coating. In this study, we [...] Read more.
Polydopamine (PDA) is a synthetic eumelanin polymer mimicking the biopolymer secreted by mussels to attach to surfaces with a high binding strength. It exhibits unique adhesive properties and has recently attracted considerable interest as a multifunctional thin film coating. In this study, we demonstrate that a PDA coating on silica- and polymer-based materials improves the entrapment and retention of uremic toxins produced in specific diseases. The low-cost natural nanotextured fossil diatomaceous earth (DE), an abundant source of mesoporous silica, and polyvinylpyrrolidone-co-Styrene (PVP-co-S), a commercial absorbent comprising polymeric particles, were easily coated with a PDA layer by oxidative polymerization of dopamine at mild basic aqueous conditions. An in-depth chemical-physical investigation of both the resulting PDA-coated materials was performed by SEM, AFM, UV-visible, Raman spectroscopy and spectroscopic ellipsometry. Finally, the obtained hybrid systems were successfully tested for the removal of two uremic toxins (indoxyl sulfate and p-cresyl sulfate) directly from patients’ sera. Full article
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins (2022))
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10 pages, 985 KiB  
Article
Potassium Bioaccessibility in Uncooked and Cooked Plant Foods: Results from a Static In Vitro Digestion Methodology
by Costanza Ceccanti, Lucia Guidi, Claudia D’Alessandro and Adamasco Cupisti
Toxins 2022, 14(10), 668; https://doi.org/10.3390/toxins14100668 - 26 Sep 2022
Cited by 8 | Viewed by 3650
Abstract
Hyperkalemia is a major concern in chronic kidney disease and in end-stage renal disease, representing a predictor of hospitalization and mortality. To prevent and treat hyperkalemia, dietary management is of great clinical interest. Currently, the growing use of plant-based diets causes an increasing [...] Read more.
Hyperkalemia is a major concern in chronic kidney disease and in end-stage renal disease, representing a predictor of hospitalization and mortality. To prevent and treat hyperkalemia, dietary management is of great clinical interest. Currently, the growing use of plant-based diets causes an increasing concern about potassium load in renal patients. The aim of this study was to assess the bioaccessibility of potassium in vegetables, concerning all aspects of the plants (fruit, flower, root, tuber, leaf and seed) and to what extent different boiling techniques affect potassium content and bioaccessibility of plant-based foods. Bioaccessibility was evaluated by an in vitro digestion methodology, resembling human gastro-intestinal tract. Potassium content was higher in seeds and leaves, despite it not being possible to define a common “rule” according to the type of organ, namely seed, leaf or fruit. Boiling reduced potassium content in all vegetables excluding carrot, zucchini, and cauliflower; boiling starting from cold water contributed to a greater reduction of the potassium content in potato, peas, and beans. Bioaccessibility after in vitro digestion ranged from 12 (peas) to 93% (tomato) regardless of species and organs. Higher bioaccessibility was found in spinach, chicory, zucchini, tomato, kiwi, and cauliflower, and lower bioaccessibility in peas. Potassium from leaf resulted in the highest bioaccessibility after digestion; as a whole potassium bioaccessibility in the fruits and vegetables studied was 67% on average, with differences in relation to the different organs and species. Further, considering the method of boiling to reduce potassium content, these data indicate that the effective potassium load from plant-based foods may be lower than originally expected. This supports the clinical advices to maintain a wide use of plant-based food in the management of renal patients. Full article
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins (2022))
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Review

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20 pages, 1230 KiB  
Review
Biotics (Pre-, Pro-, Post-) and Uremic Toxicity: Implications, Mechanisms, and Possible Therapies
by Laura Mitrea, Mădălina Medeleanu, Carmen-Rodica Pop, Ancuța-Mihaela Rotar and Dan-Cristian Vodnar
Toxins 2023, 15(9), 548; https://doi.org/10.3390/toxins15090548 - 4 Sep 2023
Cited by 6 | Viewed by 2070
Abstract
In recent years, more scientific data have pointed out the close connection between intestinal microbial community, nutritional habits, lifestyle, and the appearance of various affections located at certain anatomical systems. Gut dysbiosis enhances the formation and accumulation of specific metabolites with toxic potential [...] Read more.
In recent years, more scientific data have pointed out the close connection between intestinal microbial community, nutritional habits, lifestyle, and the appearance of various affections located at certain anatomical systems. Gut dysbiosis enhances the formation and accumulation of specific metabolites with toxic potential that induce the appearance of kidney-associated illnesses. Intestinal microbes are involved in the degradation of food, drugs, or other ingested products that lead to the formation of various metabolites that end up in renal tissue. Over the last few years, the possibilities of modulating the gut microbiota for the biosynthesis of targeted compounds with bioactive properties for reducing the risk of chronic illness development were investigated. In this regard, the present narrative review provides an overview of the scientific literature across the last decade considering the relationship between bioactive compounds, pre-, pro-, and post-biotics, uremic toxicity, and kidney-associated affections, and the possibility of alleviating the accumulation and the negative effects of uremic toxins into the renal system. Full article
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins (2022))
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22 pages, 1786 KiB  
Review
Fecal Microbiota Transplantation in Reducing Uremic Toxins Accumulation in Kidney Disease: Current Understanding and Future Perspectives
by Gianvito Caggiano, Alessandra Stasi, Rossana Franzin, Marco Fiorentino, Maria Teresa Cimmarusti, Annamaria Deleonardis, Rita Palieri, Paola Pontrelli and Loreto Gesualdo
Toxins 2023, 15(2), 115; https://doi.org/10.3390/toxins15020115 - 31 Jan 2023
Cited by 14 | Viewed by 3303
Abstract
During the past decades, the gut microbiome emerged as a key player in kidney disease. Dysbiosis-related uremic toxins together with pro-inflammatory mediators are the main factors in a deteriorating kidney function. The toxicity of uremic compounds has been well-documented in a plethora of [...] Read more.
During the past decades, the gut microbiome emerged as a key player in kidney disease. Dysbiosis-related uremic toxins together with pro-inflammatory mediators are the main factors in a deteriorating kidney function. The toxicity of uremic compounds has been well-documented in a plethora of pathophysiological mechanisms in kidney disease, such as cardiovascular injury (CVI), metabolic dysfunction, and inflammation. Accumulating data on the detrimental effect of uremic solutes in kidney disease supported the development of many strategies to restore eubiosis. Fecal microbiota transplantation (FMT) spread as an encouraging treatment for different dysbiosis-associated disorders. In this scenario, flourishing studies indicate that fecal transplantation could represent a novel treatment to reduce the uremic toxins accumulation. Here, we present the state-of-the-art concerning the application of FMT on kidney disease to restore eubiosis and reverse the retention of uremic toxins. Full article
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins (2022))
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18 pages, 2085 KiB  
Review
Adsorption- and Displacement-Based Approaches for the Removal of Protein-Bound Uremic Toxins
by Flávia S. C. Rodrigues and Mónica Faria
Toxins 2023, 15(2), 110; https://doi.org/10.3390/toxins15020110 - 28 Jan 2023
Cited by 10 | Viewed by 2686
Abstract
End-stage renal disease (ESRD) patients rely on renal replacement therapies to survive. Hemodialysis (HD), the most widely applied treatment, is responsible for the removal of excess fluid and uremic toxins (UTs) from blood, particularly those with low molecular weight (MW < 500 Da). [...] Read more.
End-stage renal disease (ESRD) patients rely on renal replacement therapies to survive. Hemodialysis (HD), the most widely applied treatment, is responsible for the removal of excess fluid and uremic toxins (UTs) from blood, particularly those with low molecular weight (MW < 500 Da). The development of high-flux membranes and more efficient treatment modes, such as hemodiafiltration, have resulted in improved removal rates of UTs in the middle molecular weight range. However, the concentrations of protein-bound uremic toxins (PBUTs) remain essentially untouched. Due to the high binding affinity to large proteins, such as albumin, PBUTs form large complexes (MW > 66 kDa) which are not removed during HD and their accumulation has been strongly associated with the increased morbidity and mortality of patients with ESRD. In this review, we describe adsorption- and displacement-based approaches currently being studied to enhance the removal of PBUTs. The development of mixed matrix membranes (MMMs) with selective adsorption properties, infusion of compounds capable of displacing UTs from their binding site on albumin, and competitive binding membranes show promising results, but the road to clinical application is still long, and further investigation is required. Full article
(This article belongs to the Special Issue New Strategies for the Reduction of Uremic Toxins (2022))
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