The Interplay Between Uremic Toxins and Albumin, Membrane Transporters and Drug Interaction

Overview

Journal Toxins (Basel)

Publisher MDPI

Specialty Toxicology

Date 2022 Mar 24

PMID 35324674

Authors

Regiane Stafim da Cunha

Carolina Amaral Bueno Azevedo

Carlos Alexandre Falconi

Fernanda Fogaca Ruiz

Sophie Liabeuf

Marcela Sorelli Carneiro-Ramos

Andrea Emilia Marques Stinghen

Affiliations

Soon will be listed here.

Abstract

Uremic toxins are a heterogeneous group of molecules that accumulate in the body due to the progression of chronic kidney disease (CKD). These toxins are associated with kidney dysfunction and the development of comorbidities in patients with CKD, being only partially eliminated by dialysis therapies. Importantly, drugs used in clinical treatments may affect the levels of uremic toxins, their tissue disposition, and even their elimination through the interaction of both with proteins such as albumin and cell membrane transporters. In this context, protein-bound uremic toxins (PBUTs) are highlighted for their high affinity for albumin, the most abundant serum protein with multiple binding sites and an ability to interact with drugs. Membrane transporters mediate the cellular influx and efflux of various uremic toxins, which may also compete with drugs as substrates, and both may alter transporter activity or expression. Therefore, this review explores the interaction mechanisms between uremic toxins and albumin, as well as membrane transporters, considering their potential relationship with drugs used in clinical practice.

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