[Trimethylamine-N-oxide and cardiovascular events in chronic kidney disease]

Trimethylamine-N-oxide (TMAO) is a biologically active molecule which is metabolized by intestinal microflora and excreted by the kidney. The incidence and mortality of cardiovascular disease (CVD) in patients with chronic kidney disease (CKD) are significantly increased, which seriously affects the prognosis of patients with CKD. Recent studies have shown that TMAO can cause myocardial fibrosis and cardiovascular damage. Plasma TMAO levels are elevated in CKD patients, and TMAO was an independent predictor for all-cause mortality in patients with CKD, including CVD events. As a "uremic toxin", TMAO can promote the progression and the occurrence of CVD in CKD patients through its toxic effects, such as inflammatory response and oxidative stress. Taken together, it may suggest that reducing TMAO production and plasma TMAO levels may decrease the occurrence of CVD events in CKD and that TMAO may be a therapeutic target for ameliorating the prognosis of CKD.