Palabras clave
toxina urémica
bisfenol A
enfermedad crónica renal
disruptor endocrino
hemodiálisis.
bisfenol A
enfermedad crónica renal
disruptor endocrino
hemodiálisis.
Cómo citar
1.
Bosch Panadero E, Mas Fontao S, Ruiz Priego A, Egido J, González Parra E. Bisfenol (A) una toxina a tener en cuenta en el enfermo renal en hemodiálisis. Rev. Colomb. Nefrol. [Internet]. 15 de marzo de 2017 [citado 20 de enero de 2025];4(1):57-68. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/256
Resumen
Muchas toxinas urémicas son originadas como consecuencia del catabolismo proteico por la flora intestinal. El metabolismo de aminoácidos aromáticos origina residuos de tipo fenólico. De estas toxinas, la más estudiada es el p-cresol, que se asocia a la función renal y daño vascular. El Bisfenol A (BPA) es una molécula exógena de características semejantes a estas toxinas urémicas aromáticas. El BPA es un disruptor endocrino estrogénico que se encuentra en latas de conserva, botellas de plástico, resinas epoxi y en algunos dializadores. Esta molécula se acumula en pacientes que tienen deteriorada la función renal. Estudios observacionales han demostrado que una exposición a BPA está vinculada, entre otras muchas, a lesión renal y cardiovascular en los seres humanos; en estudios en animales se ha descrito un vínculo causal. Los riñones con función renal normal excretan rápidamente BPA, pero una excreción insuficiente en pacientes con ERC da lugar a la acumulación del BPA en el organismo.
Citas
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Disponible en: https://doi.org/10.1681/ASN.2007121377
3. Wikoff WR, Anfora AT, Liu J, Schultz PG, Lesley SA, Peters EC, et al. Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites. Proc Natl Acad Sci U S A [Internet]. 2009 [accedido 01 Jan 2000];106(10):3698-703.
Disponible en: https://doi.org 10.1073/pnas.0812874106
4. Goldfarb DS, Modersitzki F, Asplin JR. A randomized, controlled trial oflactic acid bacteria for idiopathic hyperoxaluria. Clin J Am Soc Nephrol [Internet]. 2007 [accedido 01 Jan 2000];2(4):745-9. Disponible en: https://doi.org/10.2215/CJN.00600207
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6. Jourde-Chiche N, Dou L, Cerini C, Dignat-George F, Vanholder R, Brunet P. Progress in Uremic Toxic Research: Protein-bound toxins Update 2009. Semin Dial [Internet]. 2009 [accedido 01 Jan 2000];22(4):334-9. Disponible en:
https://doi.org/10.1111j.1525-139X.2009.00576.x
7. Martinez AW, Recht NS, Hostetter TH, Meyer TW. Removal of P-cresol sulfate by hemodialysis. J Am Soc Nephrol [Internet]. 2005 [accedido 01 Jan 2000];16(11):3430-6.
Disponible en: https://doi.org/10.1681/ASN.2005030310
8. Meijers BKI, Bammens B, De Moor B, Verbeke K, Vanrenterghem Y, Evenepoel P. Free p-cresol is associated with cardiovascular disease in hemodialysis patients. Kidney Int [Internet]. 2008 [accedido 01 Jan 2000];73(10):1174-80.
Disponible en: https://doi.org/10.1038ki.2008.31
9. Schmidt S, Westhoff TH, Krauser P, Zidek W, van der Giet M. The uraemic toxin phenylacetic acid increases the formation of reactive oxygen species in vascular smooth muscle cells. Nephrol Dial Transplant [Internet]. 2008 [accedido 01 Jan 2000];23(1):65-71.
Disponible en:https://doi.org/10.1093/ndt/gfm475
10. Yano S, Yamaguchi T, Kanazawa I, Ogawa N, Hayashi K, Yamauchi M, et al. The uraemic toxin phenylacetic acid inhibits osteoblastic proliferation and differentiation: an implication for the pathogenesis of low turnover bone in chronic renal failure. Nephrol Dial Transplant [Internet]. 2007 [accedido 01 Jan 2000];22(11):3160-5. Disponible en: https://doi.org/10.1093/ndt/gfm455
11. Raff AC, Meyer TW, Hostetter TH. New insights into uremic toxicity. Curr Opin Nephrol Hypertens [Internet]. 2008 [accedido 01 Jun 2000];17(6):560-5.
Disponible en: https://doi.org/10.1097/MNH. 0b013e32830f45b6
12. Faure V, Dou L, Sabatier F, Cerini C, Sampol J, Berland Y, et al. Elevation of circulating endothelial microparticles in patients with chronic renal failure. J Thromb Haemost [Internet]. 2006 [accedido 01Jun 2000];4(3):566-73.
Disponible en: https://doi.org/10.1111j.1538-7836.2005.01780.x
13. Motojima M, Hosokawa A, Yamato H, Muraki T, Yoshioka T. Uremic toxins of organic anions up-regulate PAI-1 expression by induction of NF-kappaB and free radical in proximal tubular cells. KidneyInt [Internet]. 2003 [accedido 01 Jun 2000];63(5):1671–80. Disponible en: https://doi.org/10.1046/j.1523-1755.2003.00906.x
14. Satoh M, Hayashi H, Watanabe M, Ueda K, Yamato H, Yoshioka T, et al. Uremic toxins overload accelerates renal damage in a rat model of chronic renal failure. Nephron Exp Nephrol[Internet]. 2003 [accedido 01 Jun 2000];95(3):e111-8. Disponible en: https://doi.org/10.1159/000074327
15. Meijers BKI, Evenepoel P. The gut-kidney axis: indoxyl sulfate, p-cresyl sulfate and CKD progression. Nephrol Dial Transplant [Internet]. 2011 [accedido 01 Jun 2000];26(3):759-61.
Disponible en: https://doi.org10.1093/ndt/gfq818
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Disponible en: https://doi.org10.2215/CJN.03980609
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19. Lekawanvijit S, Adrahtas A, Kelly DJ, Kompa AR, Wang BH, Krum H. Does indoxyl sulfate, a uraemic toxin, have direct effects on cardiac fibroblasts and myocytes? Eur Heart J [Internet]. 2010 [accedido 01 Jun 2000];31(14):1771-9.
Disponible en: https://doi.org/10.1093/eurheartj/ehp574
20. Chiang C-K, Tanaka T, Inagi R, Fujita T, Nangaku M. Indoxyl sulfate, a representative uremic toxin, suppresses erythropoietin production in a HIF-dependent manner. Lab Invest [Internet]. 2011[accedido 01 Jun 2000];91(11):1564-71.
Disponible en: https://doi.org/10.1038 labinvest.2011.114
21. Nii-Kono T, Iwasaki Y, Uchida M, Fujieda A, Hosokawa A, Motojima M, et al. Indoxyl sulfate inducesskeletal resistance to parathyroid hormone in cultured osteoblastic cells. Kidney Int [Internet]. 2007 [accedido 01 Jun 2000];71(8):738-43. Disponible en: https://doi.org/10.1038sj.ki.5002097
22. Dodds EC, Goldberg L, Lawson W, Robinson R. OEstrogenic Activity of Certain Synthetic Compounds. Nature [Internet].1938 [accedido 01 Jun 2000];141:247-8. Disponible en: https://doi.org/10.1038/141247b0
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Disponible en: https://doi.org/10.1038nrneph.2015.94
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Disponible en: https://doi.org/10.1289ehp.7534
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32. Boeniger MF, Lowry LK, Rosenberg J. Interpretation of urine results used to assess chemical exposure with emphasis on creatinine adjustments: a review. Am Ind Hyg Assoc J [Internet]. 1993 [accedido 01 Jun 2000]; 54(10):615-27.
Disponible en: https://doi.org/10.108015298669391355134
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bisphenol.
2. Vanholder R, Baurmeister U, Brunet P, Cohen G, Glorieux G, Jankowski J. A bench to bedside view of uremic toxins. J Am Soc Nephrol [Internet]. 2008 [accedido 01 Jan 2000];19(5):863-70.
Disponible en: https://doi.org/10.1681/ASN.2007121377
3. Wikoff WR, Anfora AT, Liu J, Schultz PG, Lesley SA, Peters EC, et al. Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites. Proc Natl Acad Sci U S A [Internet]. 2009 [accedido 01 Jan 2000];106(10):3698-703.
Disponible en: https://doi.org 10.1073/pnas.0812874106
4. Goldfarb DS, Modersitzki F, Asplin JR. A randomized, controlled trial oflactic acid bacteria for idiopathic hyperoxaluria. Clin J Am Soc Nephrol [Internet]. 2007 [accedido 01 Jan 2000];2(4):745-9. Disponible en: https://doi.org/10.2215/CJN.00600207
5. Bammens B, Evenepoel P, Verbeke K, Vanrenterghem Y. Removal of the protein-bound solute p-cresol by convective transport: a randomized crossover study. Am J Kidney Dis [Internet]. 2004 [accedido 01 Jan 2000]; 44(2):278-85. Disponible en: https://doi.org/10.1053/j.ajkd.2004.04.033
6. Jourde-Chiche N, Dou L, Cerini C, Dignat-George F, Vanholder R, Brunet P. Progress in Uremic Toxic Research: Protein-bound toxins Update 2009. Semin Dial [Internet]. 2009 [accedido 01 Jan 2000];22(4):334-9. Disponible en:
https://doi.org/10.1111j.1525-139X.2009.00576.x
7. Martinez AW, Recht NS, Hostetter TH, Meyer TW. Removal of P-cresol sulfate by hemodialysis. J Am Soc Nephrol [Internet]. 2005 [accedido 01 Jan 2000];16(11):3430-6.
Disponible en: https://doi.org/10.1681/ASN.2005030310
8. Meijers BKI, Bammens B, De Moor B, Verbeke K, Vanrenterghem Y, Evenepoel P. Free p-cresol is associated with cardiovascular disease in hemodialysis patients. Kidney Int [Internet]. 2008 [accedido 01 Jan 2000];73(10):1174-80.
Disponible en: https://doi.org/10.1038ki.2008.31
9. Schmidt S, Westhoff TH, Krauser P, Zidek W, van der Giet M. The uraemic toxin phenylacetic acid increases the formation of reactive oxygen species in vascular smooth muscle cells. Nephrol Dial Transplant [Internet]. 2008 [accedido 01 Jan 2000];23(1):65-71.
Disponible en:https://doi.org/10.1093/ndt/gfm475
10. Yano S, Yamaguchi T, Kanazawa I, Ogawa N, Hayashi K, Yamauchi M, et al. The uraemic toxin phenylacetic acid inhibits osteoblastic proliferation and differentiation: an implication for the pathogenesis of low turnover bone in chronic renal failure. Nephrol Dial Transplant [Internet]. 2007 [accedido 01 Jan 2000];22(11):3160-5. Disponible en: https://doi.org/10.1093/ndt/gfm455
11. Raff AC, Meyer TW, Hostetter TH. New insights into uremic toxicity. Curr Opin Nephrol Hypertens [Internet]. 2008 [accedido 01 Jun 2000];17(6):560-5.
Disponible en: https://doi.org/10.1097/MNH. 0b013e32830f45b6
12. Faure V, Dou L, Sabatier F, Cerini C, Sampol J, Berland Y, et al. Elevation of circulating endothelial microparticles in patients with chronic renal failure. J Thromb Haemost [Internet]. 2006 [accedido 01Jun 2000];4(3):566-73.
Disponible en: https://doi.org/10.1111j.1538-7836.2005.01780.x
13. Motojima M, Hosokawa A, Yamato H, Muraki T, Yoshioka T. Uremic toxins of organic anions up-regulate PAI-1 expression by induction of NF-kappaB and free radical in proximal tubular cells. KidneyInt [Internet]. 2003 [accedido 01 Jun 2000];63(5):1671–80. Disponible en: https://doi.org/10.1046/j.1523-1755.2003.00906.x
14. Satoh M, Hayashi H, Watanabe M, Ueda K, Yamato H, Yoshioka T, et al. Uremic toxins overload accelerates renal damage in a rat model of chronic renal failure. Nephron Exp Nephrol[Internet]. 2003 [accedido 01 Jun 2000];95(3):e111-8. Disponible en: https://doi.org/10.1159/000074327
15. Meijers BKI, Evenepoel P. The gut-kidney axis: indoxyl sulfate, p-cresyl sulfate and CKD progression. Nephrol Dial Transplant [Internet]. 2011 [accedido 01 Jun 2000];26(3):759-61.
Disponible en: https://doi.org10.1093/ndt/gfq818
16. Wu I-W, Hsu K-H, Lee C-C, Sun C-Y, Hsu H-J, Tsai C-J, et al. p-Cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. Nephrol Dial Transplant [Internet]. 2011 [accedido 01 Jun 2000];26(3):938-47. Disponible en: https://doi.org/10.1093/ndt/gfq580
17. Barreto FC, Barreto DV, Liabeuf S, Meert N, Glorieux G, Temmar M, et al. Serum indoxyl sulfate is associated with vascular disease and mortality in chronic kidney disease patients. Clin J Am Soc Nephrol [Internet]. 2009 [accedido 01 Jun 2000];4(10):1551-8.
Disponible en: https://doi.org10.2215/CJN.03980609
18. Yamamoto H, Tsuruoka S, Ioka T, Ando H, Ito C, Akimoto T, et al. Indoxyl sulfate stimulates proliferation of rat vascular smooth muscle cells. Kidney Int [Internet]. 2006 [accedido 01 Jun 2000];69(10):1780-5. Disponible en: https://doi.org/10.1038/sj.ki.5000340
19. Lekawanvijit S, Adrahtas A, Kelly DJ, Kompa AR, Wang BH, Krum H. Does indoxyl sulfate, a uraemic toxin, have direct effects on cardiac fibroblasts and myocytes? Eur Heart J [Internet]. 2010 [accedido 01 Jun 2000];31(14):1771-9.
Disponible en: https://doi.org/10.1093/eurheartj/ehp574
20. Chiang C-K, Tanaka T, Inagi R, Fujita T, Nangaku M. Indoxyl sulfate, a representative uremic toxin, suppresses erythropoietin production in a HIF-dependent manner. Lab Invest [Internet]. 2011[accedido 01 Jun 2000];91(11):1564-71.
Disponible en: https://doi.org/10.1038 labinvest.2011.114
21. Nii-Kono T, Iwasaki Y, Uchida M, Fujieda A, Hosokawa A, Motojima M, et al. Indoxyl sulfate inducesskeletal resistance to parathyroid hormone in cultured osteoblastic cells. Kidney Int [Internet]. 2007 [accedido 01 Jun 2000];71(8):738-43. Disponible en: https://doi.org/10.1038sj.ki.5002097
22. Dodds EC, Goldberg L, Lawson W, Robinson R. OEstrogenic Activity of Certain Synthetic Compounds. Nature [Internet].1938 [accedido 01 Jun 2000];141:247-8. Disponible en: https://doi.org/10.1038/141247b0
23. Casajuana N, Lacorte S. New methodology for the determination of phthalate esters, bisphenol A, bisphenol A diglycidyl ether, and nonylphenol in commercial whole milk samples. J Agric Food Chem [Internet]. 2004 [accedido 01 Jun 2000];52(12):3702-7. Disponible en: https://doi.org/10.1021/jf040027s
24. Thomson BM, Grounds PR. Bisphenol A in canned foods in New Zealand: an exposure assessment. Food Addit Contam [Internet]. 2005 [accedido 01 Jun 2000];22(1):65-72. Disponible en: https://doi. org/10.1080/02652030400027920
25. Dekant W, Volkel W. Human exposure to bisphenol A by biomonitoring: methods, results and assessment of environmental exposures. Toxicol Appl Pharmacol [Internet]. 2008 [accedido 01 Jun 2000];228(1):114-34. Disponible en: https://doi.org/10.1016 j.taap.2007.12.008
26. U.S. Food and Drug Administration. Draft Assessment of Bisphenol A for Use in Food Contract Applications [Internet]. 2008 [accedido 01 Jun 2000]:1-105. Disponible en: https://www.fda.gov/ohrms/dockets/ac/08 briefing/2008-0038b1_01_02_FDA%20BPA%20Draft%20Assessment.pd
27. Davidson I, Gallieni M, Saxena R, Dolmatch B. A patient centered decision making dialysis access algorithm. J Vasc Access [Internet]. 2007 [accedido 01 Jun 2000];8(2):59-68. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/17534790
28. Kataria A, Trasande L, Trachtman H. The effects of environmental chemicals on renal function. Nat Rev Nephrol [Internet]. 2015 [accedido 01 Jun 2000];11(10):610-25.
Disponible en: https://doi.org/10.1038nrneph.2015.94
29. Calafat AM, Kuklenyik Z, Reidy JA, Caudill SP, Ekong J, Needham LL. Urinary concentrations of bisphenol A and 4-nonylphenol in a human reference population. Environ Health Perspect [Internet]. 2005 [accedido 01 Jun 2000];113(4):391-5.
Disponible en: https://doi.org/10.1289ehp.7534
30. Cutanda F, Koch HM, Esteban M, Sanchez J, Angerer J, Castano A. Urinary levels of eight phthalate metabolites and bisphenol A in mother-hild pairs from two Spanish locations. Int J Hyg Environ Health [Internet]. 2015 [accedido 01 Jun 2000];218(1):47-57. Disponible en: https://doi.org10.1016/j.ijheh.2014.07.005
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