{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:15:00Z","timestamp":1787030100643,"version":"build-2736575974"},"reference-count":199,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Cardiorenal syndrome (CRS) is described as primary dysfunction in the heart culminating in renal injury or vice versa. CRS can be classified into five groups, and uremic toxin (UT) accumulation is observed in all types of CRS. Protein-bound uremic toxin (PBUT) accumulation is responsible for permanent damage to the renal tissue, and mainly occurs in CRS types 3 and 4, thus compromising renal function directly leading to a reduction in the glomerular filtration rate (GFR) and\/or subsequent proteinuria. With this decrease in GFR, patients may need renal replacement therapy (RRT), such as peritoneal dialysis (PD). PD is a high-quality and home-based dialysis therapy for patients with end-stage renal disease (ESRD) and is based on the semi-permeable characteristics of the peritoneum. These patients are exposed to factors which may cause several modifications on the peritoneal membrane. The presence of UT may harm the peritoneum membrane, which in turn can lead to the formation of extracellular vesicles (EVs). EVs are released by almost all cell types and contain lipids, nucleic acids, metabolites, membrane proteins, and cytosolic components from their cell origin. Our research group previously demonstrated that the EVs can be related to endothelial dysfunction and are formed when UTs are in contact with the endothelial monolayer. In this scenario, this review explores the mechanisms of EV formation in CRS, uremia, the peritoneum, and as potential biomarkers in peritoneal dialysis.<\/jats:p>","DOI":"10.3390\/toxins13110778","type":"journal-article","created":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T22:25:54Z","timestamp":1636064754000},"page":"778","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Extracellular Vesicles and Their Relationship with the Heart\u2013Kidney Axis, Uremia and Peritoneal Dialysis"],"prefix":"10.3390","volume":"13","author":[{"given":"Carolina Amaral Bueno","family":"Azevedo","sequence":"first","affiliation":[{"name":"Experimental Nephrology Laboratory, Basic Pathology Department, Universidade Federal do Paran\u00e1, Curitiba 81531-980, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regiane Stafim","family":"da Cunha","sequence":"additional","affiliation":[{"name":"Experimental Nephrology Laboratory, Basic Pathology Department, Universidade Federal do Paran\u00e1, Curitiba 81531-980, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-7050","authenticated-orcid":false,"given":"Carolina Victoria Cruz","family":"Junho","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Immunology, Center of Natural and Human Sciences (CCNH), Federal University of ABC, Santo Andr\u00e9 09210-580, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Ver\u00f4nica","family":"da Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Immunology, Center of Natural and Human Sciences (CCNH), Federal University of ABC, Santo Andr\u00e9 09210-580, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2730-2952","authenticated-orcid":false,"given":"Andr\u00e9a N.","family":"Moreno-Amaral","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paran\u00e1, Curitiba 80215-901, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2983-3968","authenticated-orcid":false,"given":"Thyago Proen\u00e7a","family":"de Moraes","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paran\u00e1, Curitiba 80215-901, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2666-1280","authenticated-orcid":false,"given":"Marcela Sorelli","family":"Carneiro-Ramos","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Immunology, Center of Natural and Human Sciences (CCNH), Federal University of ABC, Santo Andr\u00e9 09210-580, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8595-5321","authenticated-orcid":false,"given":"Andr\u00e9a Emilia Marques","family":"Stinghen","sequence":"additional","affiliation":[{"name":"Experimental Nephrology Laboratory, Basic Pathology Department, Universidade Federal do Paran\u00e1, Curitiba 81531-980, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.ccl.2019.04.001","article-title":"Cardiorenal Syndrome: Pathophysiology","volume":"37","author":"Kumar","year":"2019","journal-title":"Cardiol. 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