The role of uremic toxins on the development of cardiovascular damages

7th International Congress of Cardionephrology KARNEF (2025) [pp. 27-34]

AUTHOR(S) / АУТОР(И): Dejan Pilčević , Violeta Rabrenović, Milica Petrović, Neven Vavić, Nemanja Đenić

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DOI: 10.46793/KARNEF25.027P

ABSTRACT / САЖЕТАК:

Uvod: Uremijski toksini (UTs) igraju važnu ulogu u razvoju kardiovaskularnih bolesti (KVB) kod pacijenata sa hroničnim bolestima bubrega (HBB). Povezani su sa značajnim kardiovaskularnim morbiditetom i mortalitetom ovih pacijenata.

Pacijenti i metode: UTs se definišu kao štetni produkti koji se akumuliraju u organizmu tokom sniženja filtracione sposobnosti bubrega, dok ih zdravi bubrezi normalno izlučuju. Potiču iz endogenog metabolizma, mikrobnog metabolizma ili egzogenog unosa. Sva uremična jedinjenja imaju negativnu ulogu u biološkim funkcijama uzrokujući brojne poremećaje u različitim tkivima kod ljudi sa HBB, uključujući kardiovaskularni sistem. Literaturno se opisuje više od 140 UTs koji se promovišu tokom razvoja bubrežne disfunkcije. Biološki efekti koje prouzrokuju zavise od međusobnog odnosa sinteze, degradacije, eliminacije, intracelularne distribucije i prisustva inhibitora ili promotera delovanja toksina.

Rezultati: Brojni UTs kao što su indoksil sulfat, cijanat, modifikovani LDL, uznapredovali završni proizvodi glikozilacije, p-krezol i p-krezol sulfat, fosfati, mokraćna kiselina i asimetrični dimetilarginin doprinose razvoju ateromatoznih i neateromatoznih kardiovaskularnih oštećenja kod pacijenata sa HBB kroz različite mehanizame od kojih su najznačajniji endotelna disfunkcija i vaskularna kalcifikacija uzrokovani uglavnom oksidativnim stresom i inflamacijom.

Zaključak: Pouzdani dokazi sugerišu da su uremijski toksini ozbiljna opasnost po kardiovasku-larni sistem u HBB i kao takvi mogu predstavljati nove biomarkere i terapijske ciljeve kod ovih pacijenata

KEYWORDS / КЉУЧНЕ РЕЧИ:

uremijski toksini, kardiovaskularna oboljenja, bubrežna disfunkcija, inflamacija

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