p-Cresyl Sulfate.
If chronic kidney disease (CKD) is associated with an impairment of kidney function, several uremic solutes are retained. Some of these exert toxic effects, which are called uremic toxins.p-Cresyl sulfate (pCS) is a prototype protein-bound uremic toxin to which many biological and biochemical (toxic) effects have been attributed. In addition, increased levels of pCS have been associated with worsening outcomes in CKD patients. pCS finds its origin in the intestine where gut bacteria metabolize aromatic amino acids, such as tyrosine and phenylalanine, leading to phenolic end products, of which pCS is one of the components. In this review we summarize the biological effects of pCS and its metabolic origin in the intestine. It appears that, according toin vitrostudies, the intestinal bacteria generating phenolic compounds mainly belong to the familiesBacteroidaceae, Bifidobacteriaceae, Clostridiaceae, Enterobacteriaceae, Enterococcaceae, Eubacteriaceae, Fusobacteriaceae, Lachnospiraceae, Lactobacillaceae, Porphyromonadaceae, Staphylococcaceae, Ruminococcaceae, andVeillonellaceae. Since pCS remains difficult to remove by dialysis, the gut microbiota could be a future target to decrease pCS levels and its toxicity, even at earlier stages of CKD, aiming at slowing down the progression of the disease and decreasing the cardiovascular burden.
Department of Internal Medicine, Nephrology Division, Ghent University Hospital, 9000 Ghent, Belgium. tessa.gryp@ugent.be.|Laboratory for Bacteriology Research, Department of Clinical Chemistry, Microbiology & Immunology, Ghent University, 9000 Ghent, Belgium. tessa.gryp@ugent.be.
Tessa
T
Gryp
Department of Internal Medicine, Nephrology Division, Ghent University Hospital, 9000 Ghent, Belgium. raymond.vanholder@ugent.be.
Raymond
R
Vanholder
Laboratory for Bacteriology Research, Department of Clinical Chemistry, Microbiology & Immunology, Ghent University, 9000 Ghent, Belgium. mario.vaneechoutte@ugent.be.
Mario
M
Vaneechoutte
Department of Internal Medicine, Nephrology Division, Ghent University Hospital, 9000 Ghent, Belgium. griet.glorieux@ugent.be.
Griet
G
Glorieux
D000818:Animals; D001419:Bacteria / Q000378:metabolism*; D003106:Colon / Q000382:microbiology*; D003408:Cresols / Q000009:adverse effects* / Q000378:metabolism; D004044:Dietary Proteins / Q000378:metabolism; D064806:Dysbiosis; D005285:Fermentation; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D011379:Prognosis; D011485:Protein Binding; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy; D017582:Renal Replacement Therapy; D012307:Risk Factors; D013463:Sulfuric Acid Esters / Q000009:adverse effects* / Q000378:metabolism
D003408:Cresols; D004044:Dietary Proteins; D013463:Sulfuric Acid Esters; C408690:4-cresol sulfate
chronic kidney disease; intestinal microbiota; p-cresyl sulfate