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Protein-bound uremic toxins (IS, pCS, PAGln) accumulate exponentially as eGFR declines below 60 mL/min/1.73 m 2 due to saturable OAT1/3-mediated tubular secretion (113, 167), with patients at eGFR 30 exhibiting 510 higher IS than those at eGFR 90reflecting clearance impairment rather than unique pathogenic mechanisms

Adebayo GI, Williams J, Healy S (2007) Aspirin esterase activity Evidence for skewed distribution in healthy volunteers

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