A role for the uraemic toxins indoxyl sulfate and p-cresyl sulfate in the pathogenesis of cardiovascular disease has been suggested. Now, researchers report a significant and sustained increase in the levels of these toxins and a 30% decrease in renal function in 42 living kidney donors after nephrectomy. Toxin levels were significantly associated with markers of cardiovascular and renal risk and were independent predictors of change in kidney function from baseline at 2 years.