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3.1.1 Indoxyl sulfate (IS) Indoxyl sulfate (IS) is classified as a protein-bound uremic toxin, with its biosynthesis originating from tryptophan metabolism: gut microbiota first convert tryptophan into indole, which is then transported to the liver for oxidation and sulfation to form IS (Meyer and Hostetter, 2012)

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Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest