ArticleInternational urology and nephrology2018
From bench to the hemodialysis clinic: protein-bound uremic toxins modulate NF-κB/Nrf2 expression.
Article in International urology and nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 47 citations in OpenAlex.
- Effects of Propolis Supplementation on Gut Microbiota and Uremic Toxin Profiles of Patients Undergoing Hemodialysis.Toxins · 2024Trial
- Curcumin supplementation improves oxidative stress and inflammation biomarkers in patients undergoing hemodialysis: a secondary analysis of a randomized controlled trial.International urology and nephrology · 2022Trial
- High-volume hemodiafiltration decreases the pre-dialysis concentrations of indoxyl sulfate and p-cresyl sulfate compared to hemodialysis: a post-hoc analysis from the HDFit randomized controlled trial.Journal of nephrology · 2022Trial
- Can curcumin supplementation reduce plasma levels of gut-derived uremic toxins in hemodialysis patients? A pilot randomized, double-blind, controlled study.International urology and nephrology · 2021Trial
- Muscle strength, neuromuscular function, and functional measures across stages of chronic kidney disease.BMC nephrology · 2026Article
- Molecular frontiers in hemodialysis: unraveling the role of membranes in gene expression, epigenetics, and inflammatory pathways.International urology and nephrology · 2025Review
- Chronic Kidney Disease and Osteoarthritis: Current Understanding and Future Research Directions.International journal of molecular sciences · 2025Review
- Pathophysiology of vascular ageing and the effect of novel cardio-renal protective medications in preventing progression of chronic kidney disease in people living with diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2025Review
- Targeting gut microbiota for diabetic nephropathy treatment: probiotics, dietary interventions, and fecal microbiota transplantation.Frontiers in endocrinology · 2025Review
- Pathogenesis of Sarcopenia in Chronic Kidney Disease-The Role of Inflammation, Metabolic Dysregulation, Gut Dysbiosis, and microRNA.International journal of molecular sciences · 2024Review
- Review
- Association of serum Nrf2 protein levels with disease activity and renal impairment in lupus nephritis.Frontiers in immunology · 2024Article
- Cutaneous adaptive immunity and uraemia: a narrative review.Frontiers in immunology · 2024Review
- Saikosaponin A protects against uremic toxin indole‑3 acetic acid‑induced damage to the myocardium.Molecular medicine reports · 2023Article
- Review
- Nrf2 Protein Serum Concentration in Human CKD Shows a Biphasic Behavior.Antioxidants (Basel, Switzerland) · 2023Article
- Implications of Senescent Cell Burden and NRF2 Pathway in Uremic Calcification: A Translational Study.Cells · 2023Article
- Nrf2 Activation in Chronic Kidney Disease: Promises and Pitfalls.Antioxidants (Basel, Switzerland) · 2022Review
- The interaction between cellular senescence and chronic kidney disease as a therapeutic opportunity.Frontiers in pharmacology · 2022Review
- Chronic Kidney Disease and Cancer: Inter-Relationships and Mechanisms.Frontiers in cell and developmental biology · 2022Review
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeUremic toxins produced by gut microbiota (indoxyl sulfate-IS, p-cresyl sulfate-p-CS, and indole-3-acetic acid-IAA) accumulate in hemodialysis (HD) patients and exhibit potent inflammatory effects. However, the impact of these toxins on nuclear E2-related factor 2 (Nrf2) and nuclear factor-kappa B (NF-κB) expression in HD patients remains poorly defined. The aim of this study was to evaluate the association between uremic toxins and Nrf2/NF-κB expression in vitro (RAW 264.7 macrophage-like cells) and in peripheral blood mononuclear cells from HD patients.
methodsUremic toxins, C-reactive protein (CRP), interleukin-6 (IL-6) and malondialdehyde (MDA) levels were measured in fifteen HD patients and nine healthy individuals. RAW 264.7 macrophage-like cells were incubated with IS, as a prototype of protein-bound uremic toxin. Nrf2 and NF-κB expressions were analyzed by RT-qPCR.
resultsHD patients presented high levels of inflammatory markers, MDA and uremic toxins. In addition, they presented high NF-κB and low Nrf2 expression. Uremic toxins were positively correlated with NF-κB expression (IS, ρ = 0.58, p < 0.003; p-CS, ρ = 0.71, p < 0.001; IAA, ρ = 0.62, p < 0.001) and negatively with Nrf2 (IS, ρ = - 0.48, p = 0.01; p-CS, ρ = - 0.46, p < 0.02). Uremic toxins also exhibited positive correlations with CRP and MDA levels. Multivariate analysis revealed that p-CS is a determinant factor of NF-κB expression. In RAW 264.7 culture, NF-κB mRNA expression was stimulated by IS, while Nrf2 was downregulated.
conclusionsThus, uremic toxins may stimulate NF-κB mRNA and decrease Nrf2 expression in HD patients and, consequently, trigger inflammation and oxidative stress.
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