Indoxyl glucuronide is an indole compound that is formed through gut microbial metabolism from dietary tryptophan and a glucuronidation reaction in liver hepatic cells. After being transported into gut microbes, tryptophan undergoes a reaction with the enzyme tryptophanase to form indole. Indole that is produced from the gut microbes then enters systemic circulation. Ultimately it undergoes a reaction in a liver hepatocyte through a glucuronosyltransferase enzyme to form Indoxyl glucuronide. When this compound returns back into systemic circulation it is shown to be a major uremic toxin through high levels of retention. Indoxyl glucuronide is shown to cause a reduction in Erythropoetin production which ultimately results in renal anemia.

Metabolism and Physiological Effects of Indoxyl glucuronide References