Toluene is not only used industrially, but it is also the most widely abusively inhaled solvent. High-flux dialysis removes no more p-cresol than conventional dialysis [unpublished observation]. P-cresol, a uremic compound, enhances the uptake of aluminum in hepatocytes. Stange J, Ramlow W, Mitzner S, Schmidt R, Klinkmann H. Dialysis against a recycled albumin solution enables the removal of albumin-bound toxins. Geypens B, Claus D, Evenepoel P et al. In view of the disappointingly low removal by the classical dialysis methods, alternative methods to decrease plasma concentration should be considered. Whether such manoeuvres would remove clinically relevant quantities of p-cresol remains an open question. p-Cresol is metabolized through conjugation, mainly sulphation and glucuronization [1,2], but removal of the unconjugated p-cresol is, at least in part, via the urine . p-Cresol is one of the metabolites of the amino acid tyrosine, and to a certain extent also of phenylalanine, which are converted to 4-hydroxyphenylacetic acid by intestinal bacteria, before being decarboxylated to p-cresol (putrefaction) . Evenepoel P, Claus D, Geypens B et al. Although such systems are available for clinical use, especially in acute hepatic failure, it will be difficult to obtain cost-effective results on the long run in chronic dialysis patients. In addition, there is no correlation between the removal of the current markers urea and creatinine, and that of p-cresol [unpublished observation]. p-Cresol in the intestine of uraemic rats can be adsorbed by the administration of the oral sorbant AST-120, resulting in a decrease of serum p-cresol . Vanholder R, De Smet R, Waterloos MA et al. Articles of p-Amino-o-cresol are included as well. In its chemical structure, a molecule of cresol has a methyl group substituted onto the ring of phenol. The rest is produced by hydrolysis of chlorotoluenesor the related sulfonates. Shifting from a conventional diet to an uncooked vegan diet reversably alters fecal hydrolytic activities in humans. The main contributing bacteria are aerobes (mainly enterobacteria), but to a certain extent also anaerobes play a role (mainly Clostridium perfringens) . In healthy controls, virtually no free p-cresol could be found; in contrast, in haemodialysed patients, protein binding was only ±90%. P-Cresol is an end-product of protein breakdown, and an increase of the nutritional protein load in healthy individuals results in enhanced generation and urinary excretion . Unfortunately, AST-120 is not available outside Japan. Free p-cresol averaged 11±9 μmol/l, with as highest registered value 25 μmol/l. The metabolism of the abortifacient terpene, (R)-(+)-pulegone, to a proximate toxin, menthofuran. In Vitro Toxicity Studies: Cell proliferation: DNA incorporation, mitotic index etc. The effect was dose dependent. Evidence for impaired assimilation and increased colonic fermentation of protein, related to gastric acid suppression therapy.