Kidney and Metabolic Bone Diseases Vol.26 No.3(8)

Theme Regulation, disease states and drug targets of kidney tubular transporters -- Topics
Title Uremic toxin transport in chronic kidney disease
Publish Date 2013/08
Author Yasutoshi Akiyama Department of Community Medical Supports, Tohoku Medical Megabank Organization (ToMMo), Tohoku University / Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital
Author Takaaki Abe Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital / Division of Medical Science, Tohoku University Graduate School of Biomedical Engineering / Department of Clinical Biology and Hormonal Regulation, Tohoku University
[ Summary ] The kidneys are involved in the elimination of various intrinsic and extrinsic compounds from the body, and in the regulation of homeostasis and pharmacokinetics. The secretion and reabsorption of organic solutes in the kidneys is made possible by cooperative transport by various transporters expressed at the apical or basolateral surface of tubular cells. A growing body of evidence suggests that some transporters are involved in the transport of not only drugs and metabolites but also uremic toxins. In addition, it has been reported that the expression levels of these transporters changes with renal failure. It has been suggested that changes in expression are involved in the pathophysiology of CKD, such as tissue-specific toxicity and the clearance of uremic toxins. In this review, we will provide an overview of the transport of uremic toxins by these transporters in association with CKD. We also present our recent findings on the mechanism of SLCO4C1 down-regulation by indoxyl sulfate and clinical implications.
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