 The uremic syndrome is caused by the buildup of toxins in the body due to impaired kidney function. These toxins can cause damage to various organs including the heart, leading to increased risk of cardiovascular diseases. Indoxal sulfate and p-cressal sulfate are two types of protein-bound uremic toxins that have been found to be associated with cardiovascular disease in patients with chronic kidney disease. While both toxins are known to cause similar damage, it appears that p-cressal sulfate has more severe consequences than indoxal sulfate. Further research is needed to determine how best to treat these toxins and reduce their negative effects on the cardiovascular system. This article was authored by Ziad A. Massey, Sophie Lea Booth, and Tillman B. Druck.