Classification of Uremic Toxins and Their Role in Kidney Failure

被引：168

作者：

Rosner, Mitchell H. ^{[1
]}

Reis, Thiago ^{[2
,3
]}

Husain-Syed, Faeq ^{[4
]}

Vanholder, Raymond ^{[5
]}

Hutchison, Colin ^{[6
,7
]}

Stenvinkel, Peter ^{[8
]}

Blankestijn, Peter J. ^{[9
]}

Cozzolino, Mario ^{[10
]}

Juillard, Laurent ^{[11
,12
]}

Kashani, Kianoush ^{[13
]}

Kaushik, Manish ^{[14
]}

Kawanishi, Hideki ^{[15
]}

Massy, Ziad ^{[16
,17
]}

Sirich, Tammy Lisa ^{[18
,19
]}

Zuo, Li ^{[20
]}

Ronco, Claudio ^{[21
,22
]}

机构：

[1] Univ Virginia Hlth Syst, Div Nephrol, Charlottesville, VA USA

[2] Univ Brazil, Dept Nephrol, Brasilia, DF, Brazil

[3] Natl Acad Med, Rio De Janeiro, Brazil

[4] Justus Liebig Univ Giessen, Dept Internal Med 2, Giessen, Germany

[5] Univ Hosp, Dept Internal Med & Pediat, Ghent, Belgium

[6] Univ Queensland, Fac Med, Herston, Qld, Australia

[7] Hawkes Bay Dist Hlth Board, Dept Med, Hastings, New Zealand

[8] Karolinska Univ Hosp, Renal Med, Stockholm, Sweden

[9] Univ Med Ctr Utrecht, Dept Hypertens & Nephrol, Utrecht, Netherlands

[10] Univ Milan, Div Renal, Milan, Italy

[11] Univ Lyon, Villeurbanne, France

[12] Hop Edouard Herriot, Lyon, France

[13] Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USA

[14] Singapore Gen Hosp, Dept Renal Med, Singapore, Singapore

[15] Tsuchiya Gen Hosp, Dept Artificial Organs, Hiroshima, Japan

[16] INSERM U1018, Villejuif, France

[17] Hop Univ Ambroise Pare, Serv Nephrol & Dialyse, Boulogne Billancourt, France

[18] Vet Affairs Palo Alto Hlth Care Syst, Nephrol Sect, Palo Alto, CA USA

[19] Stanford Univ, Div Nephrol, Sch Med, Stanford, CA USA

[20] Peking Univ, Dept Nephrol, Peoples Hosp, Beijing, Peoples R China

[21] Univ Padua, Dept Med, Padua, Italy

[22] Int Renal Res Inst Vicenza, Dept Nephrol Dialysis & Transplantat, Vicenza, Italy

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2021年 / 16卷 / 12期

关键词：

uremia; dialysis; middle molecule; definition; classification; HEMODIALYSIS-PATIENTS; REMOVAL; PROTEIN; UREA; MEMBRANES; SOLUTES; DISEASE;

D O I：

10.2215/CJN.02660221

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1918 / 1928

页数：11

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