Classification of Uremic Toxins and Their Role in Kidney Failure

  • Mitchell H. Rosner
    Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia
  • Thiago Reis
    Department of Nephrology, University of Brazil, Brasília, Brazil
  • Faeq Husain-Syed
    Department of Internal Medicine II, Justus-Liebig-University Giessen, Giessen, Germany
  • Raymond Vanholder
    Department of Internal Medicine and Pediatrics, University Hospital, Ghent, Belgium
  • Colin Hutchison
    Faculty of Medicine, University of Queensland, Herston, Australia
  • Peter Stenvinkel
    Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
  • Peter J. Blankestijn
    Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, The Netherlands
  • Mario Cozzolino
    Renal Division, Università degli Studi di Milano, Milan, Italy
  • Laurent Juillard
    University of Lyon, Villeurbanne, France
  • Kianoush Kashani
    Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
  • Manish Kaushik
    Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
  • Hideki Kawanishi
    Department of Artificial Organs, Tsuchiya General Hospital, Hiroshima, Japan
  • Ziad Massy
    INSERM U1018, Villejuif, France
  • Tammy Lisa Sirich
    Nephrology Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
  • Li Zuo
    Department of Nephrology, Peking University People's Hospital, Beijing, China
  • Claudio Ronco
    Department of Medicine, University of Padova, Padova, Italy

抄録

<jats:p>Advances in our understanding of uremic retention solutes, and improvements in hemodialysis membranes and other techniques designed to remove uremic retention solutes, offer opportunities to readdress the definition and classification of uremic toxins. A consensus conference was held to develop recommendations for an updated definition and classification scheme on the basis of a holistic approach that incorporates physicochemical characteristics and dialytic removal patterns of uremic retention solutes and their linkage to clinical symptoms and outcomes. The major focus is on the removal of uremic retention solutes by hemodialysis. The identification of representative biomarkers for different classes of uremic retention solutes and their correlation to clinical symptoms and outcomes may facilitate personalized and targeted dialysis prescriptions to improve quality of life, morbidity, and mortality. Recommendations for areas of future research were also formulated, aimed at improving understanding of uremic solutes and improving outcomes in patients with CKD.</jats:p>

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