Patients
with chronic kidney disease (CKD) have an enhanced risk of
cardiovascular (CV) morbidity and mortality when compared to age and gender
-
matched individuals
with normal kidney function
. Trimethlyamine
-
N
-
oxide
(TM
AO)
is a gut
-
der
ived amine oxide that has been implicated in the causation of
cardiovascular diseases. Plasma TMAO is cleared by the kidney and TMAO levels
are elevated in CKD. Experimental studies have identified pathogenic
mechanisms by which TMAO may contribute to card
iovascular disease through
dysregulation of lipid metabolism, enhanced macrophage foam cell formation
and platelet dysfunction. Safe and well tolerated therapeutic interventions such
as pre
-
and probiotics, which modify the gut microbiome, offer the opport
unity
for interventional studies.
This review examines the
pathogenicity of TMAO, its
value as a biomarker
and its potential as a therapeutic target in the context of
CKD