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Indoxyl sulfate production and actions. Indoxyl sulfate is the product of gut bacterial tryptophanase and hepatic hydroxylation and sulfation. It is 95% albumin bound. Renal excretion, which serves to remove bound and free IS, is mediated by OAT 1 and OAT 3 in proximal renal tubule where signaling events and elimination occur. Free (unbound) IS can act as a signaling molecule on distant tissues bearing EGF receptors.
