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Uremic Toxins Panel Quantification Service (PBUTs) — LC-MS/MS (MRM)

Uremic toxins are a heterogeneous group of metabolites that can accumulate when clearance is reduced or when production is altered (e.g., gut-derived pathways). A key subgroup is protein-bound uremic toxins (PBUTs) such as indoxyl sulfate (IS) and p-cresyl sulfate (pCS), which often require high-selectivity targeted LC-MS/MS methods to obtain reliable absolute concentrations in complex matrices.

This service provides targeted, quantitative measurement of PBUTs and related uremic solutes using triple-quadrupole LC-MS/MS in MRM mode, with batch-level QA/QC and concentration reporting suitable for cross-timepoint and cross-cohort comparisons.

Key Highlights

  • Core & Custom Panels: Comprehensive coverage of PBUTs with flexible add-ons for specific pathway research.
  • Precision Quantification: High-selectivity MRM methods delivering traceable absolute concentrations (μM / ng/mL).
  • Free vs. Total Analysis: Optional workflows to quantify protein-binding effects and determine Free Fraction (%).
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Background & Why Analyze Uremic Toxins

Protein-Bound Uremic Toxins (PBUTs): Why targeted quantification matters

PBUTs and related uremic solutes often show:

  • Strong matrix effects (serum/plasma/urine/dialysate vary widely).
  • Protein binding (total concentration may not reflect the diffusible portion).
  • Broad dynamic range across subjects, timepoints, and interventions.

What problems we solve (research & industrial R&D)

  • Convert relative signals into traceable absolute concentrations (μM / ng/mL) for robust statistics, modeling, and reporting.
  • Support Free vs Total PBUTs study designs to quantify protein-binding effects and to compute Free fraction (%).
  • Provide batch QA/QC documentation so your quantitative conclusions are reproducible and defensible across large studies.

What We Offer: Uremic Toxins Targeted Quantification Services

Core Quantification

Absolute quantification of key uremic toxins, including indoxyl sulfate, p-cresyl sulfate, and IAA, using LC-MS/MS (MRM).

Delivered as structured panel output with concentration values (μM or ng/mL), LOQ-aware flags, and batch-level QA/QC.

Customizable Panels

Extendable to include gut-derived aromatic acids, conjugated metabolites, and co-factors (e.g., hippuric acid, phenyl sulfate, ADMA, TMAO). Feasibility assessed based on matrix, target list, and expected range

Optional Modules

  • Free vs Total quantification: Includes free concentration, total concentration, and Free fraction (%)
  • Extended dynamic range or high-sensitivity setup for low-abundance targets
  • Cross-batch harmonization for longitudinal or multi-cohort projects

Detectable Analytes: Uremic Toxins Panel List

Final panel can be Core only or Core + Extensions, and is customizable based on your study and matrix.

Category Analytes Included Default Tier
Core PBUTs Indoxyl sulfate (IS); p-Cresyl sulfate (pCS); Indole-3-acetic acid (IAA) Core
Gut-derived aromatic acids & related uremic solutes Hippuric acid; Phenylacetic acid (PAA); Phenylacetylglutamine (PAGln); Phenyl sulfate; 4-Hydroxyphenylacetic acid (4-HPAA); 4-Hydroxybenzoic acid (4-HBA); Benzoic acid; p-Cresol (handling-dependent); Indole-3-propionic acid (IPA); Indole-3-lactic acid (ILA); Indole-3-carboxylic acid (ICA); Skatole (3-methylindole) (feasibility-dependent) Optional
Conjugated indoles/phenols Indoxyl glucuronide (IG); p-Cresyl glucuronide (pCG) On request (standards/IS-dependent)
Methylarginines & nitrogen-handling context ADMA; SDMA; Arginine; Citrulline; Ornithine (study-driven) Optional
Tryptophan–kynurenine pathway Tryptophan (Trp); Kynurenine (Kyn); Kynurenic acid (KA); Quinolinic acid (QA); Xanthurenic acid (XA); 3-Hydroxykynurenine (3-HK) (stability/handling assessed) Optional / On request
Related "uremic milieu" co-readouts Trimethylamine N-oxide (TMAO); Choline; Betaine; Carnitine (optional metabolic context) Optional

Custom list welcome: If your target analytes are not listed, send the list + matrix + expected range. We will confirm feasibility and propose an optimized panel.

Quantitative Performance & Data Quality Highlights

  • Absolute concentration outputs (μM / ng/mL) with LOQ-aware flags suitable for statistics and modeling.
  • Selectivity for closely related metabolites via MRM transitions (quantifier + qualifier) and retention-time checks.
  • Typical precision targets: intra-/inter-batch CV commonly ≤15% (low-level points may be ≤20%; matrix/analyte dependent).
  • Typical calibration performance targets: weighted regression with R² ≥ 0.99 (panel- and matrix-dependent).
  • Dynamic range built for cohort studies: commonly 2–4 orders of magnitude depending on analyte and matrix.
  • Optional Free vs Total PBUTs: outputs Free, Total, and Free fraction (%) for PBUT-focused designs.

Analytical Workflow for Targeted Uremic Toxins Analysis

1

Study intake

Targets, matrix, sample number, timepoints, expected range, Free/Total requirement

2

Feasibility & plan

Standards/internal standard strategy, sample prep route, calibration & QC design

3

Sample receiving

Manifest check, condition logging, storage verification

4

Sample preparation

Total: protein precipitation / cleanup (SPE when needed)

Free (optional): ultrafiltration/separation workflow with controlled conditions

5

LC-MS/MS acquisition (MRM)

Batch sequence includes blanks, calibrators, QCs, and study samples

6

Data processing & QA/QC

Integration rules, ion ratio checks, drift review, LOQ handling

Uremic Toxins Panel Analysis Workflow

Analytical Platforms for PBUTs / Uremic Toxins Quantification

Our PBUTs panel analysis is performed on an Agilent 1290 Infinity II UHPLC system coupled with an Agilent 6495C Triple Quadrupole Mass Spectrometer, optimized for high-sensitivity targeted quantification in complex matrices (e.g., plasma, serum, urine, dialysate).

Key Instrument Parameters

Component Parameter Specification (Typical)
UHPLC Column C18, 2.1 mm × 100 mm, 1.8 μm
Flow rate 0.3–0.5 mL/min
Run time 8–15 min/sample
Mobile phase Water / acetonitrile with 0.1% formic acid or ammonium buffer (panel-dependent)
MS/MS Ion source ESI (+/− mode, compound-dependent)
Acquisition mode MRM (quantifier + qualifier)
Dwell time 5–25 ms per transition
Cycle time 0.3–1.0 s (≥10–12 points/peak)
Mass range m/z 50–1000

Instrument configuration ensures accurate detection of low-abundance PBUTs with minimized matrix interference and high reproducibility.

Agilent 1290 Infinity II HPLC

Agilent 1290 Infinity II HPLC (Figure from Agilent)

Agilent 6495C Triple quadrupole

Agilent 6495C Triple quadrupole (Figure from Agilent)

Sample Types & Submission Requirements

We accept the following sample types for PBUTs and related uremic solutes quantification:

Sample Type Recommended Volume Container Notes Storage Shipping
Serum 100–200 µL 1.5–2.0 mL screw-cap tube Avoid hemolysis; aliquot to minimize freeze–thaw cycles −80 °C Dry ice
Plasma 150–300 µL Screw-cap tube Use consistent anticoagulant across samples (e.g., EDTA or Heparin) −80 °C Dry ice
Urine 200–500 µL Screw-cap tube Mix well before aliquoting; indicate collection type (e.g., spot, 24 h) −80 °C Dry ice
Dialysate 300–500 µL Screw-cap tube Record collection timepoints and dialysis conditions −80 °C Dry ice

Additional Notes:

  • Limit freeze–thaw cycles to ≤2
  • Provide a complete sample manifest: sample ID, matrix, volume, group, collection timepoint
  • Animal samples (e.g., rat/mouse plasma, urine) are accepted upon request
  • Fecal samples may be accepted for specific precursor analysis — contact us for feasibility evaluation

Deliverables: Quantitative Data Package and QC Report

  • Quantification results table (Excel/CSV): absolute concentrations (μM and/or ng/mL) per analyte per sample + LOQ flags.
  • Free/Total table (Excel/CSV, if selected): Free, Total, and Free fraction (%).
  • Batch QC report (PDF): calibration summary + QC performance + carryover check.
  • Peak integration export (Excel/CSV): RT, transitions, peak areas/ratios, integration flags.
  • MRM transition list (Excel/PDF): quantifier/qualifier transitions + RT windows.
  • Sample receipt log (Excel/PDF): manifest check + condition notes.
  • Raw data files (on request): vendor raw ± mzML.
  • Methods summary (PDF): prep overview + key parameters + LOQ rules.
Four-panel MRM chromatograms with sample/calibrator/blank overlays, RT windows, and quantifier/qualifier transitions for IS, pCS, IAA, and HA.

Representative LC–MS/MS MRM chromatograms for IS, pCS, IAA, and HA in matrix: sample, calibrator, and blank overlaid with RT window shading and quantifier/qualifier transitions.

Four analyte calibration panels showing weighted fits, LOQ markers, and residual/accuracy versus concentration.

Weighted calibration curves with LOQ markers and aligned residual (or accuracy) plots versus concentration for targeted LC–MS/MS quantification of uremic-toxin analytes.

Applications in PBUTs and Uremic Toxin Quantification Research

CKD & Uremia Mechanism Research

Quantify PBUTs (IS, pCS, IAA) and related solutes across groups/timepoints to study gut-derived metabolic shifts and kidney excretory dysfunction.

Dialysis Efficacy & Kinetics

Measure pre/post-dialysis and rebound concentrations (e.g., 0 h / 2 h / 24 h) to assess clearance efficiency and kinetic profiles.

Membrane / Sorbent / Adsorbent Development

Compare Total vs Free PBUT levels to evaluate adsorption performance and protein-binding limitations of new dialysis materials.

Microbiome & Dietary Interventions

Track changes in indole/phenyl metabolites and their conjugates to assess microbial or nutritional modulation of uremic toxin pathways.

Drug / Nutraceutical Screening

Use absolute PBUT concentrations as pharmacodynamic endpoints in preclinical or human studies to evaluate metabolic response.

Cohort Studies & Multi-omics Integration

Generate standardized quantitative features for association analysis and integration with metagenomics, transcriptomics, or proteomics.

How do you ensure accurate quantification of protein-bound versus free PBUTs?

We use a standardized ultrafiltration step to separate the free fraction under controlled conditions (temperature, pH, membrane cutoff). Total concentrations are measured from a separate aliquot using protein precipitation. Both fractions are quantified against stable-isotope internal standards to ensure comparability.

Why is LC-MS/MS MRM preferred over ELISA for uremic toxins?

ELISA kits often suffer from cross-reactivity between similar metabolites, leading to inaccurate measurements. LC-MS/MS in MRM mode provides superior specificity by chromatographically separating compounds and detecting unique precursor-to-product ion transitions, ensuring precise quantification of the target toxin.

Can you handle samples with high urea or salt concentrations, like dialysate?

Yes, our protocols mitigate matrix effects from high-salt or high-urea backgrounds. We use matrix-matched calibration curves and internal standards to compensate for ion suppression, ensuring accurate quantification across different sample types.

What happens if a sample's concentration exceeds the calibration range?

Samples above the upper limit of quantification (ULOQ) are flagged and diluted using an appropriate blank matrix. The sample is then re-analyzed, and the final concentration is corrected for dilution.

Are measurements of unstable precursors like Indole or p-Cresol reliable?

Volatile precursors are unstable and may degrade during handling. We recommend measuring their stable end-products, such as Indoxyl Sulfate (IS) and p-Cresyl Sulfate (pCS), for more reliable data. If precursor data is essential, we require a consultation to establish a specialized collection and stabilization protocol.

Can I send tissues or fecal samples for analysis?

Yes, but these require a custom feasibility assessment. Tissue and fecal samples need specialized homogenization and extraction protocols. Please provide sample details for an optimized workflow.

Do you provide collection kits or tubes for Free/Total analysis?

We do not provide physical kits but offer a detailed Standard Operating Procedure (SOP) for sample collection, handling, and storage. The SOP specifies the required tubes and anticoagulants to ensure compatibility with the Free/Total quantification workflow.

What is the difference between free and total indoxyl sulfate?

Total indoxyl sulfate includes both bound and free forms, with the bound fraction bound to plasma proteins like albumin. Free indoxyl sulfate is the unbound, biologically active form, which can pass through membranes and is more readily cleared by dialysis. Measuring both fractions helps assess toxin activity and clearance efficiency.

Why are stable-isotope internal standards used in PBUT analysis?

Stable-isotope internal standards (e.g., deuterated IS or pCS) correct for variability in extraction recovery and MS response, ensuring accurate absolute quantification. They have nearly identical chemical properties but a different mass from the target analytes.

Which uremic toxins are considered protein-bound?

Key protein-bound uremic toxins (PBUTs) include indoxyl sulfate (IS) and p-cresyl sulfate (pCS). Other metabolites like indole-3-acetic acid (IAA), hippuric acid, and kynurenine also exhibit significant protein binding, which limits their clearance during hemodialysis.

How are uremic toxin concentrations reported?

Concentrations are typically reported in micromolar (μM) or nanograms per milliliter (ng/mL). The final data package includes absolute concentrations for each analyte, with LOQ flags and, for Free/Total studies, the Free Fraction (%) calculated and reported.

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