This thesis is concerned with applying engineering principles to the use of polymeric nanoporous adsorbents for use in blood purification to obtain original knowledge. Styrene divinylbenzene copolymer nanoporous adsorbents offer a potential means to remove middle molecular (MM) sized molecules when in direct contact with blood. (Continues...).

Resorcinarenes can be functionalized at their upper and lower rims. In this work, the upper rim of a resorcinarene was functionalized with glutamic acids and the lower rim was functionalized with either methyl or undecyl alkyl groups. The cavitands were characterized by nuclear magnetic resonance (NMR), mass spectrometry (MS), UV-vis spectroscopy, dynamic light scattering (DLS) and electron microscopy. The binding of resorcinarene with amine guests was studied in DMSO by UV-vis titration. The obtained binding constants (K values) were in the range of 12,000-136000 M-1. The resorcinarenes were shown to form aggregates in a variety of solvents. The aggregates were spherical as confirmed by DLS, SEM and TEM experiments. Dynamic light scattering (DLS) experiments revealed the size of the aggregates could be controlled by cavitand concentration, pH, and temperature. The resorcinarene with undecyl alkyl group were adsorbed onto 55% cross-linked styrene-divinylbenzene resin to prepare a new stationary phases for ion chromatography (IC) columns. The new column packing material was applied in determination of uremic toxins and water contaminants. The new IC column afforded separation of the five uremic toxins : guanidinoacetic acid, guanidine, methylguanidine, creatinine, and guanidinobenzoic acid in 30 minutes. Detection and quantification of uremic toxins helps diagnose kidney problems and start patient care. Gradient elutions at ambient temperature with methanesulfonic acid (MSA) as eluent resulted in detection levels in water from 10 to 47 ppb and in synthetic urine from 28 to 180 ppb. Trace levels of creatinine (1 ppt) were detected in the urine of a healthy individual using the columns. The new IC stationary phase separated cationic pharmaceuticals including a group of guanidine compounds in surface water. Detection limits in the range of 5 - 32 µg L-1 were achieved using integrated pulsed amperometric detection (IPAD) for guanidine (G), methylguanidine (MG), 1,1-dimethylbiguanidine (DMG), agmatine (AGM), guanidinobenzoic acid (GBA) and cimetidine (CIM). Suppressed conductivity (CD) and UV-vis detection resulted in limits of detection similar to IPAD, in the range of 1.7 - 66 µg L-1, but were not able to detect all of the analytes. Three water sources, river, lake, and marsh, were analyzed and despite matrix effects, sensitivity for guanidine compounds was in the 100 µg L-1 range and apparent recoveries were 80-96 %. The peak area precision was 0.01 - 2.89% for IPAD, CD and UV-vis detection.

Bien que l'insulino-résistance soit une caractéristique connue de la maladie rénale chronique (MRC), les mécanismes impliqués sont encore mal compris. Le p-crésol est un produit toxique généré par la transformation de la tyrosine par la flore bactérienne intestinale. Son sulfoconjugué, le p-crésyl sulfate (PCS) a été identifié comme le principal métabolite circulant du p-crésol chez l'homme et est considéré comme une importante toxine urémique liée aux protéines. En effet, les concentrations de PCS sont corrélées de façon indépendante à la morbi-mortalité cardiovasculaire présente chez les patients ayant une MRC. Le but de cette étude est de déterminer le rôle du PCS dans l'insulino-résistance associée à la MRC. L'administration chronique de PCS (10mg/kg, deux fois par jour pendant 4 semaines) chez des souris ayant une fonction rénale normale induit une insulino-résistance ainsi qu'une perte de masse grasse et une redistribution ectopique de lipides dans le muscle et le foie (lipotoxicité), ce qui est observé chez les souris ayant une MRC. Le PCS perturbe la signalisation de l'insuline dans les muscles squelettiques des souris par l'activation des kinases ERK 1/2. L'incubation in vitro de myotubes C2C12 avec du PCS à des concentrations retrouvées (40 μg/ml) chez les patients ayant une MRC terminale induit également une insulino-résistance par le biais d'une activation directe d’ERK1/2. Le traitement de souris urémiques avec un prébiotique (arabino-xylo-oligosaccharide, AXOS) qui diminue la production intestinale de p-crésol et donc la concentration de PCS dans le sérum, améliore significativement les paramètres métaboliques. Ces données suggèrent que le PCS participe à l'insulino-résistance associée à la MRC. Du fait d’une faible élimination par les techniques conventionnelles de dialyse, des thérapeutiques alternatives tels que les prébiotiques, diminuant la production de PCS, pourraient diminuer la mortalité cardio-vasculaire associée à la MRC / Although insulin resistance is a well-documented feature of chronic kidney disease (CKD), the underlying mechanisms remain poorly understood. p-cresol is a toxic by product generated by transformation of tyrosine by intestinal microbiota. Its conjugate p-cresyl sulfate (PCS) is identified as the main circulating metabolite of p-cresol and a major protein bound uremic toxin. PCS is independently associated with mortality and cardiovascular disease in CKD patients. The aim of this study was to determine the role of PCS in CKD-associated insulin-resistance. Chronic administration of PCS (10mg/kg, twice daily for 4 weeks) in mice with normal kidney function triggered insulin resistance, fat mass loss and ectopic lipid redistribution in muscle and liver (lipotoxicity) mimicking those associated to CKD. PCS mice revealed altered insulin signaling in skeletal muscle through ERK1/2 activation. Exposition of C2C12 myotubes to PCS at CKD-relevant concentrations (40 μg/ml) caused insulin resistance, also through a direct activation of ERK1/2. Mouse models of surgically induced renal failure displayed insulin resistance and dyslipidemia, and treatment with a prebiotic (arabino-xylo-oligosaccharide) reducing p-cresol intestinal production and thus serum PCS, prevented these metabolic defects. These data suggest that although PCS is poorly removed by the common dialysis techniques, alternative therapeutic such prebiotics ttargeting of PCS may prevent metabolic abnormalities associated to end-stage renal disease

Kidney failure results in fluid and toxin accumulation within body fluid compartments, contributing to the excess mortality seen in this condition. Such uremic toxins have been measured in plasma, with levels assumed to reflect extraplasmatic concentrations such as in interstitial fluid (ISF). ISF is separated from plasma by nanometre-order microvascular pores; toxins may not circulate “freely” between the two compartments. This work set out to characterise the ISF in uremic subjects, with the hypothesis that there may be differences with plasma. Any such difference may be clinically relevant, owing to the much larger size of the ISF compartment, its proximity to cell metabolic processes, and its expansion in renal impairment.We used a modified microdialysis technique to successfully sample subcorneal ISF of some the uremic toxins (urea, creatinine, urate, phosphate). Reverse iontophoresis (RI) was also used as a non-invasive technique to sample epidermal ISF of urea. Hollow microneedles were developed and their ability to extract ISF tested in CKD patients and controls. The mechanical properties (pressure, volume, permeability) and biochemical composition (proteomic and metabolomic profiles) of the interstitial compartment were also investigated.Microdialysis and RI performed very well as interstitial uremic toxin sampling techniques. Small differences were seen in steady states between ISF and plasma urea, creatinine, phosphate and urate, with slightly lower ISF levels. Dialysis seemed to enhance this difference, with a lag in the clearance of ISF toxins seen in some patients, most remarkable with phosphate. Metabolomic analysis identified several uremic toxins in ISF, whilst proteomics found some significant differences between the two compartments, with toxins like beta-2 microglobulin occurring in ISF only. Microneedle arrays successfully extracted ISF in 68.8% of patients with oedema. Successful extraction of ISF with microneedles occurred mainly in oedematous patients, who were found to have raised interstitial pressures (ISP) and volumes. ISP correlated significantly with body fluid volumes and seemed time-dependent, lower in more chronic oedema. ISP and volumes also correlated with the oedema depitting time (after thumb pressure), a potential novel parameter that probably relates to tissue hydraulic conductivity and hence volume status and fluid mobility within the interstitium.This study demonstrates that interstitial fluid may need to be considered as a separate active compartment in patients with renal dysfunction, with a different “uremic" composition and unique pathophysiological characteristics that cannot be explained by blood compartment based measurements alone. There is a need for more studies, to further characterise this compartment and elucidate its importance.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-17T20:42:43Z No. of bitstreams: 1 Gabriela Gomes Cardoso Rodrigues.pdf: 623885 bytes, checksum: 3da3d1230fd77beffc9c12f00be889bb (MD5) / Made available in DSpace on 2016-05-17T20:42:43Z (GMT). No. of bitstreams: 1 Gabriela Gomes Cardoso Rodrigues.pdf: 623885 bytes, checksum: 3da3d1230fd77beffc9c12f00be889bb (MD5) Previous issue date: 2015-02-04 / Chronic kidney disease (CKD) is characterized by progressive and irreversible loss of renal function and often progresses with a muscular weakness, whose set of signs and symptoms is generally referred to as uremic myopathy. Possible risk factors for the uremic myopathy are the uremic toxins. Among uremic toxins, indoxyl sulfate (IS) is a derivative of tryptophan metabolism by intestinal bacteria. Because skeletal muscle tissue undergo constant remodeling due differentiation of myoblasts in myotubes, it is possible that uremic toxins have a deleterious effect to influence this process, exacerbating the uremic myopathy. Low level laser therapy (LLLT) is regarded as a growth promoter feature widely used in the treatment of chronic diseases and has shown positive effects on the modulation of skeletal muscle repair process and also in the process of inflammation. However, in the context of CKD, the LLLT has not yet been explored. The aim of this study was to evaluate the effects of the IS on cell viability and on oxidative stress on cellular differentiation in cultured C2C12 myoblasts. In addition, to verify the action of the LLLT as a protective alternative to the cells. The C2C12 myoblasts were cultured in DMEM culture medium containing 10% fetal bovine serum and were induced to differentiation process by adding 2% horse serum. Three different IS concentrations were used to mimic the plasma concentrations of normal individual, CKD patients with moderate uremia and CKD patients with advanced uremia (0.6 mg/l and 53 mg/l and 236 mg/l, respectively), at different times of incubation (24 h, 48 h and 72 h). Subsequently, the cells were subjected to treatment with LLLT GaAlAs 780 nm (output power 10 mW, 20 seconds application time and energy density of 0.5 J / cm2). In terms of analysis, we used MTT method to assess the viability of the cells, flow cytometry to assess the viability/cell death and oxidative stress, nitrite dosing to evaluate nitric oxide production and real-time PCR to analyze IL-6, myogenin and MyoD expression (inflammation and cell differentiation markers). The results demonstrate that the IS at the maximum concentration was toxic to C2C12 cells, because it significantly decreased cell viability by MTT and by flow cytometry and by increasing the percentage of necrosis. This effect was present throughout the three incubation periods. With respect to oxidative stress, was not any conclusion, probably by the time the samples, but do not rule out the possibility of IS induce this type of stress. Although the IS has induced death to C2C12 cells, the remaining had no change in cell differentiation markers. Treatment with BPL the IS sensitized cells, reducing cell viability. We conclude that the IS acts directly on C2C12 myoblasts with toxic effect and may be the one factor responsible for uremic myopathy. Treatment with LLLT was not effective in protecting the cells. / A doença renal crônica (DRC) é caracterizada pela perda progressiva e irreversível da função renal e que frequentemente cursa com um quadro de fraqueza muscular, cujo conjunto de sinais e sintomas é globalmente designado como miopatia urêmica. Possíveis fatores predisponentes para a miopatia urêmica são as toxinas urêmicas. Dentre as toxinas urêmicas, o indoxil sulfato (IS) é uma derivada do metabolismo do triptofano presente em bactérias intestinais. Devido ao fato do tecido muscular esquelético sofrer constante remodelação graças à diferenciação de mioblastos em miotubos, é possível que toxinas urêmicas tenham um efeito deletério por influenciar este processo, agravando a miopatia urêmica. A terapia a laser de baixa potência (LBP) é considerada como um recurso bioestimulante amplamente utilizado no tratamento de doenças crônicas e tem demonstrado efeitos positivos sobre a modulação do processo de reparo muscular esquelético e também no processo da inflamação. Entretanto, no contexto de DRC, o LBP não foi ainda explorado. O objetivo do presente estudo foi avaliar dos efeitos do IS sobre a viabilidade celular, sobre o estresse oxidativo e sobre a diferenciação celular em cultura de mioblastos C2C12. Além disso, verificar a ação do LBP como forma de proteção às células. Os mioblastos C2C12 foram cultivados em meio de cultura de DMEM, contendo 10% de soro fetal bovino e foram induzidos ao processo de diferenciação por meio da adição de 2% soro de cavalo. Três diferentes concentrações de IS foram usadas para mimetizar as concentrações plasmáticas de indivíduo normal, paciente DRC com uremia moderada e paciente DRC com uremia avançada (0,6 mg/l; 53 mg/l e 236 mg/l, respectivamente), em diferentes períodos de incubação (24 h, 48 h e 72 h). Posteriormente, as células foram submetidas ao tratamento com laser de baixa potência AsGaAl 780 nm (potência de saída de 10 mW, tempo de aplicação de 20 segundos e densidade de energia de 0,5 J/cm2). Como análise, foi utilizado o método MTT para acessar a viabilidade das células, citometria de fluxo para avaliar a viabilidade/mortalidade das células, bem como o estresse oxidativo, dosagem de nitrito para avaliar a produção de óxido nítrico e PCR em tempo real para analisar a expressão de IL-6, miogenina e MyoD (marcadores de inflamação e diferenciação celular). Os resultados demonstram que o IS na concentração máxima foi tóxico para as células C2C12, pois diminuiu significativamente a viabilidade das células, tanto por MTT como por citometria de fluxo, aumentando a porcentagem de necrose. Este efeito foi presente nos três períodos de incubação. Com relação ao estresse oxidativo, não foi possível nenhuma conclusão, provavelmente pelo tempo das amostras , porém não descartamos a possibilidade do IS induzir este tipo de estresse. Embora o IS tenha induzido morte às células C2C12, as remanescentes não tiveram alteração dos marcadores de diferenciação celular. O tratamento com LBP sensibilizou as células ao IS, diminuindo a viabilidade das células. Concluímos que o IS age diretamente sobre mioblastos C2C12 com efeito tóxico, podendo ser um dos responsáveis pela miopatia urêmica. O tratamento com LBP não foi eficiente na indução de proteção às células.

Patients with kidney failure (KF) have a high incidence of cardiovascular (CV) disease, partly driven by insufficient clearance of uremic toxins. Recent investigations have questioned the accepted effects of adverse lipid profile and CV risk in uremic patients. Therefore, we related a panel of uremic toxins previously associated with CV morbidity/mortality to a full lipid profile in a large, tri-national, cross-sectional cohort. Total, high-density lipoprotein (HDL), non-HDL, lowdensity lipoprotein (LDL), and remnant cholesterol, as well as triglyceride, levels were associated with five uremic toxins in a cohort of 611 adult KF patients with adjustment for clinically relevant covariates and other patient-level variables. Univariate analyses revealed negative correlations of total, non-HDL, and LDL cholesterol with all investigated uremic toxins. Multivariate linear regression analyses confirmed independent, negative associations of phenylacetylglutamine with total, non-HDL, and LDL cholesterol, while indole-3 acetic acid associated with non-HDL and LDL cholesterol. Furthermore, trimethylamine-N-Oxide was independently and negatively associated with non-HDL cholesterol. Sensitivity analyses largely confirmed findings in the entire cohort. In conclusion, significant inverse associations between lipid profile and distinct uremic toxins in KF highlight the complexity of the uremic milieu, suggesting that not all uremic toxin interactions with conventional CV risk markers may be pathogenic.

O para-cresol (4-metilfenol) e as guanidinas são compostos envolvidos em uma série de processos bioquímicos e fisiológicos. Em condições normais esses compostos são eliminados do organismo pelos rins. Entretanto, em pacientes com doença renal crônica (DRC), esses compostos acumulam nos fluidos biológicos e tecidos, e são de difícil remoção, gerando alta taxa de mortalidade em pacientes humanos hemodialisados. Cromatografia gasosa (GC) e cromatografia líquida de alta eficiência (HPLC) são as técnicas analíticas mais utilizadas para a separação e quantificação de p-cresol e guanidinas. A derivatização pré ou pós-coluna geralmente é empregada para aumentar a volatilidade, absorbância ou fluorescência desses compostos, permitindo a detecção e quantificação. A ninidrina é um dos reagentes mais utilizados para a derivatização das guandinas pois apresenta alta sensibilidade, solubilidade em água e o procedimento aplicado para a derivatização é simples, permitindo a automação do sistema de preparo de amostras quando necessário. Embora haja vários estudos sobre a concentração e os efeitos desses compostos no sangue de pacientes humanos com DRC, a concentração de p-cresol e das guanidinas no sangue de cães com DRC e os efeitos associados a tais compostos foram pouco estudados. Assim, são necessários estudos similares aos realizados em humanos, para o desenvolvimento de novas estratégias de tratamento veterinário para cães. Para isso, é importante o desenvolvimento de uma metodologia analítica para a quantificação desses compostos no sangue de cães. Nesse trabalho desenvolveu-se, validou-se e aplicou-se um método para análise de p-cresol e guanidinas em plasma de cães urêmicos com detecção por fluorescência. A reação de derivatização das guanidinas com a ninidrina foi revisada, caracterizada por espectrometria de massas (MS) e otimizada utilizando planejamento fatorial. Foi analisado um total de 63 amostras de plasma de cães incluindo grupo controle e urêmico. A concentração média de guanidina, metilguanidina e p-cresol livre determinada foi maior no grupo urêmico do que no grupo controle, a exemplo do que ocorre em humanos, sugerindo um comportamento metabólico similar desses compostos em cães. O método desenvolvido possibilitou as análises, sendo relativamente simples, evitando um preparo de amostras complexo. Por sua vez, a otimização por planejamento fatorial da reação de derivatizacão com ninidrina resultou em ganhos na área dos picos cromatográficos que chegaram a 1000%. / Para-cresol (4-methylphenol) and guanidino compounds are involved in a series of biochemical and physiological cycles. Under ordinary conditions, these compounds are excreted from the body by healthy kidneys. However, in uremic patients, the concentration of these compounds is highly increased in biological fluids and tissues and is of hard removal, increasing the mortality rate in dialysis patients. Gas chromatography (GC) and high performance liquid chromatography (HPLC) are the most used techniques for separation and quantification of p-cresol and guanidino compounds. For the guanidines determination, derivatizing reactions are usually employed to enhance the absorbance, fluorescence or volatility of these compounds, allowing the quantification. Ninhydrin is one of the most used reagents for derivatization because it shows high sensitivity and presents water solubility. The procedure employed for the derivatization reaction is simple, allowing the automation of sample preparation system, when it is required. There are few studies quantifying the concentration of guanidino compounds and p-cresol in blood of uremic dogs, therefore, a better understanding of the role of these compounds in the metabolism of dogs are needed. For this reason, it is important to develop an analytical method for the quantification of these compounds in dog\'s blood. The development of a method for simultaneous determination of these compounds, which is not reported in the literature, can improve the analytical productivity, decreasing the time spent with sample preparation and analysis. Here, a method based in reversed-phase HPLC for simultaneous quantification of guanidino compounds and free p-cresol in plasma of uremic dogs with fluorescence detection was developed, validated and applied. For this purpose, the ninhydrin derivatization reaction was reviewed, characterized by mass spectrometry (MS) and optimized using central composite design (CCD). A total of 63 samples of dog plasma, including healthy and uremic groups, were analyzed. The mean concentration of guanidine, methylguanidine and free p-cresol determined by the validated method, for the uremic group, were higher than the healthy group, alike usual for humans, suggesting a similar metabolic behavior of these compounds in dogs. The obtained method is relatively simple avoiding complex sample preparation and the experimentally designed optimization of the ninhydrin reaction by CCD yielded a gain of area as high as 1000% for the chromatographic peaks.

L'insuffisance rénale chronique (IRC) est une affection caractérisée par une perte progressive de la fonction rénale. L’IRC est associée à l'accumulation de diverses toxines urémiques. Les toxines urémiques ou solutés de rétention de l'urémie sont des composés qui s'accumulent chez les patients atteints d'IRC en raison d'un défaut de clairance rénale et qui exercent des effets biologiques délétères. Les hémodialyses éliminent mal les toxines urémiques liées aux protéines (PBUT), en raison de leur liaison aux protéines plasmatiques, en particulier la sérumalbumine humaine. En conséquence, les toxines urémiques liées aux protéines s'accumulent chez les patients atteints d'IRC et leur concentration ne peut que difficilement être diminuée chez les patients atteints d'insuffisance rénale terminale (IRT). Mes travaux sont principalement centrés sur les toxines urémiques, en particulier les toxines urémiques liées aux protéines, comme l’indoxyl-sulfate (IS), l'acide phénylacétique (PAA) et le p-crésyl-glucuronide (p-CG); et la zinc-alpha2-glycoprotéine (ZAG) qui est une « middle molécule ». Nous avons étudié le rôle de l'IS dans le développement de la résistance à l'insuline et d'autres troubles métaboliques associés à l'IRC, ainsi que ses effets sur l'inflammation et le stress oxydant. Nous avons exploré les propriétés de liaison du PAA et du p-CG à la sérumalbumine, qui est la plus abondante protéine dans le plasma humain. Enfin, nous avons essayé de développer une nouvelle stratégie d'élimination des PBUT, à l’aide de déplaceurs/compétiteurs chimique. / Chronic kidney disease (CKD) is a condition characterized by progressive loss of kidney function. CKD is associated with the accumulation of various uremic toxins. Uremic toxins or uremic retention solutes are compounds that accumulate in patients with CKD due to impaired renal clearance and exert deleterious biological effects. Protein-bound uremic toxins (PBUT) is poorly removed by hemodialysis because of its binding to plasma proteins, particularly human serum albumin. As a result, protein-bound uremic toxins accumulate in patients with CKD and their concentration can hardly be reduced in patients with end-stage renal disease (ESRD). My work focuses mainly on uremic toxins, particularly protein-bound uremic toxins such as indoxyl-sulfate (IS), phenylacetic acid (PAA) and p-cresyl-glucuronide (p-CG); and zinc-alpha2-glycoprotein (ZAG) which is a "middle molecule". We investigated the role of IS in the development of insulin resistance and other metabolic disorders associated with CKD, as well as its effects on inflammation and oxidative stress. We have investigated the binding properties of PAA and p-CG to serum albumin, which is the most abundant protein in human plasma. Finally, we tried to develop a new strategy to eliminate PBUTs, using chemical displacers / competitors.

L’Insuffisance Rénale Chronique (IRC) résulte de la destruction progressive et irréversible des reins. Elle est associée à une rétention de toxines urémiques à l’origine des nombreuses complications de la maladie rénale chronique (cardiovasculaires, osseuses ou métaboliques). Nos travaux se sont focalisés sur l’impact de la dysfonction rénale et de l’urémie sur la fonction barrière de l’intestin et la motilité intestinale. Deux modèles d’IRC ont été implémentés : un modèle animal, chez la souris, par néphrectomie chimique (régime alimentaire enrichi en adénine) et un modèle cellulaire d’urémie en incubant des cellules coliques Caco-2 avec 10% de plasma de patients hémodialysés (HD). Le transit, la motilité, la perméabilité intestinale et la régulation des protéines des jonctions serrées ont été explorés. Les animaux urémiques présentent un transit gastro-intestinal ralenti et une perméabilité intestinale augmentée associés à une dérégulation de l’expression et de l’abondance des protéines des jonctions serrées dans le côlon (surexpression de la Claudine 1). La perméabilité de la monocouche cellulaire de Caco-2 incubées avec du plasma HD est significativement augmentée et est associée à une augmentation de l’expression et de l’abondance de la Claudine-1. En IRC, la motilité digestive et la fonction barrière de l’intestin sont significativement altérées. Ces dysfonctions pourraient contribuer à la production intestinale et l’absorption des toxines urémiques accélérant ainsi la progression du syndrome urémique et installant un véritable « cercle vicieux ». / Chronic Kidney Disease (CKD) result from a progressive kidney dysfunction. CKD is associated with an increase in the concentration of uremic toxins inducing CKD-associated metabolic alterations. Our work focused on the impact of renal dysfunction on gut permeability and gut motility. In vivo, CKD was induced in mice by chemical nephrectomy (adenine-enriched diet); In vitro, Caco-2 cells were incubated for 24h with 10% (v/v) of uremic plasma to mimic the uremic environment. Gastrointestinal transit time, gut motility, intestinal permeability and expression of tight junction proteins were explored. In vivo, kidney failure was associated with an impaired gastrointestinal transit and an increased intestinal permeability associated with a dysregulation of tight junction proteins (mainly claudine-1 overexpression). The Caco-2 monolayer permeability was significantly increased in cell monolayers incubated with uremic plasma. Claudine-1 expression and abundance was increased. In CKD, gut motility and gut permeability (e.g. « leaky » gut) are significantly impaired. Generally speaking, these gut dysfunctions could promote the production and the absorption of uremic toxins contributing to the uremic syndrom.

O para-cresol (4-metilfenol) e as guanidinas são compostos envolvidos em uma série de processos bioquímicos e fisiológicos. Em condições normais esses compostos são eliminados do organismo pelos rins. Entretanto, em pacientes com doença renal crônica (DRC), esses compostos acumulam nos fluidos biológicos e tecidos, e são de difícil remoção, gerando alta taxa de mortalidade em pacientes humanos hemodialisados. Cromatografia gasosa (GC) e cromatografia líquida de alta eficiência (HPLC) são as técnicas analíticas mais utilizadas para a separação e quantificação de p-cresol e guanidinas. A derivatização pré ou pós-coluna geralmente é empregada para aumentar a volatilidade, absorbância ou fluorescência desses compostos, permitindo a detecção e quantificação. A ninidrina é um dos reagentes mais utilizados para a derivatização das guandinas pois apresenta alta sensibilidade, solubilidade em água e o procedimento aplicado para a derivatização é simples, permitindo a automação do sistema de preparo de amostras quando necessário. Embora haja vários estudos sobre a concentração e os efeitos desses compostos no sangue de pacientes humanos com DRC, a concentração de p-cresol e das guanidinas no sangue de cães com DRC e os efeitos associados a tais compostos foram pouco estudados. Assim, são necessários estudos similares aos realizados em humanos, para o desenvolvimento de novas estratégias de tratamento veterinário para cães. Para isso, é importante o desenvolvimento de uma metodologia analítica para a quantificação desses compostos no sangue de cães. Nesse trabalho desenvolveu-se, validou-se e aplicou-se um método para análise de p-cresol e guanidinas em plasma de cães urêmicos com detecção por fluorescência. A reação de derivatização das guanidinas com a ninidrina foi revisada, caracterizada por espectrometria de massas (MS) e otimizada utilizando planejamento fatorial. Foi analisado um total de 63 amostras de plasma de cães incluindo grupo controle e urêmico. A concentração média de guanidina, metilguanidina e p-cresol livre determinada foi maior no grupo urêmico do que no grupo controle, a exemplo do que ocorre em humanos, sugerindo um comportamento metabólico similar desses compostos em cães. O método desenvolvido possibilitou as análises, sendo relativamente simples, evitando um preparo de amostras complexo. Por sua vez, a otimização por planejamento fatorial da reação de derivatizacão com ninidrina resultou em ganhos na área dos picos cromatográficos que chegaram a 1000%. / Para-cresol (4-methylphenol) and guanidino compounds are involved in a series of biochemical and physiological cycles. Under ordinary conditions, these compounds are excreted from the body by healthy kidneys. However, in uremic patients, the concentration of these compounds is highly increased in biological fluids and tissues and is of hard removal, increasing the mortality rate in dialysis patients. Gas chromatography (GC) and high performance liquid chromatography (HPLC) are the most used techniques for separation and quantification of p-cresol and guanidino compounds. For the guanidines determination, derivatizing reactions are usually employed to enhance the absorbance, fluorescence or volatility of these compounds, allowing the quantification. Ninhydrin is one of the most used reagents for derivatization because it shows high sensitivity and presents water solubility. The procedure employed for the derivatization reaction is simple, allowing the automation of sample preparation system, when it is required. There are few studies quantifying the concentration of guanidino compounds and p-cresol in blood of uremic dogs, therefore, a better understanding of the role of these compounds in the metabolism of dogs are needed. For this reason, it is important to develop an analytical method for the quantification of these compounds in dog\'s blood. The development of a method for simultaneous determination of these compounds, which is not reported in the literature, can improve the analytical productivity, decreasing the time spent with sample preparation and analysis. Here, a method based in reversed-phase HPLC for simultaneous quantification of guanidino compounds and free p-cresol in plasma of uremic dogs with fluorescence detection was developed, validated and applied. For this purpose, the ninhydrin derivatization reaction was reviewed, characterized by mass spectrometry (MS) and optimized using central composite design (CCD). A total of 63 samples of dog plasma, including healthy and uremic groups, were analyzed. The mean concentration of guanidine, methylguanidine and free p-cresol determined by the validated method, for the uremic group, were higher than the healthy group, alike usual for humans, suggesting a similar metabolic behavior of these compounds in dogs. The obtained method is relatively simple avoiding complex sample preparation and the experimentally designed optimization of the ninhydrin reaction by CCD yielded a gain of area as high as 1000% for the chromatographic peaks.